袖状胃切除术和胃束带术：对血浆胃饥饿素水平的影响。

Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels.

作者信息

Langer F B, Reza Hoda M A, Bohdjalian A, Felberbauer F X, Zacherl J, Wenzl E, Schindler K, Luger A, Ludvik B, Prager G

机构信息

Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria.

出版信息

Obes Surg. 2005 Aug;15(7):1024-9. doi: 10.1381/0960892054621125.

DOI:10.1381/0960892054621125

PMID:16105401

Abstract

BACKGROUND

Different changes of plasma ghrelin levels have been reported following gastric banding, Roux-en-Y gastric bypass, and biliopancreatic diversion.

METHODS

This prospective study compares plasma ghrelin levels and weight loss following laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) in 20 patients.

RESULTS

Patients who underwent LSG (n=10) showed a significant decrease of plasma ghrelin at day 1 compared to preoperative values (35.8 +/- 12.3 fmol/ml vs 109.6 +/- 32.6 fmol/ml, P=0.005). Plasma ghrelin remained low and stable at 1 and 6 months postoperatively. In contrast, no change of plasma ghrelin at day 1 (71.8 +/- 35.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.441) was found in patients after LAGB (n=10). Increased plasma ghrelin levels compared with the preoperative levels at 1 (101.9 +/- 30.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.028) and 6 months (104.9 +/- 51.1 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.012) after surgery were observed. Mean excess weight loss was higher in the LSG group at 1 (30 +/- 13% vs 17 +/- 7%, P=0.005) and 6 months (61 +/- 16% vs 29 +/- 11%, P=0.001) compared with the LAGB group.

CONCLUSIONS

As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.

摘要

背景

据报道，胃束带术、Roux-en-Y胃旁路术和胆胰转流术后血浆胃饥饿素水平会发生不同变化。

方法

这项前瞻性研究比较了20例患者接受腹腔镜袖状胃切除术（LSG）和腹腔镜可调节胃束带术（LAGB）后的血浆胃饥饿素水平和体重减轻情况。

结果

接受LSG的患者（n = 10）在术后第1天血浆胃饥饿素水平与术前相比显著降低（35.8±12.3 fmol/ml对109.6±32.6 fmol/ml，P = 0.005）。术后1个月和6个月时血浆胃饥饿素水平保持较低且稳定。相比之下，接受LAGB的患者（n = 10）在术后第1天血浆胃饥饿素水平无变化（71.8±35.3 fmol/ml对73.7±24.8 fmol/ml，P = 0.441）。术后1个月（101.9±30.3 fmol/ml对73.7±24.8 fmol/ml，P = 0.028）和6个月（104.9±51.1 fmol/ml对73.7±24.8 fmol/ml，P = 0.012）时，血浆胃饥饿素水平较术前升高。与LAGB组相比，LSG组术后1个月（30±13%对17±7%，P = 0.005）和6个月（61±16%对29±11%，P = 0.001）时的平均超重减轻幅度更大。