Cigaina Valerio, Hirschberg Angelica Lindén
Department of General Surgery, District of Venice, Mestre Hospital, Venice, Italy, and Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
Metabolism. 2007 Aug;56(8):1017-21. doi: 10.1016/j.metabol.2007.03.007.
Gastric pacing is a new treatment of morbid obesity. Patients experience increased satiety, the ability to reduce food intake, and a resultant weight loss. We hypothesized that the appetite-stimulating hormone ghrelin is involved in the changed appetite and eating behavior resulting from gastric pacing. Eleven morbidly obese patients (mean body mass index of 46 kg/m2) were treated with gastric pacing. The peripheral blood levels of ghrelin were studied 1 month before gastric pacer implantation, 1 month after implantation, and 6 months after activation of electrical stimulation. Blood samples were drawn 12 hours after fasting and in response to a hypoenergetic meal (1130 kJ [270 kcal]). Patients were followed monthly for vital signs and weight level. Gastric pacing resulted in a significant weight loss of a mean 10.4 kg or 4.4 body mass index units after 6 months of treatment. No negative side effects or complications were observed during the treatment. Ghrelin levels decreased significantly in response to food intake at all visits. After activation of the pacemaker, levels of ghrelin were significantly increased (P<.01) as compared with before activation. Weight loss correlated significantly with increased ghrelin levels (R=0.69, P<.05). Gastric pacing is a promising therapy for morbid obesity. It is suggested that increased ghrelin after gastric pacing is an adaptation to negative energy balance without a causal role in weight loss or body weight maintenance.
胃起搏是治疗病态肥胖的一种新方法。患者会感到饱腹感增强，有减少食物摄入量的能力，从而导致体重减轻。我们推测，食欲刺激激素胃饥饿素参与了胃起搏引起的食欲和饮食行为变化。11例病态肥胖患者（平均体重指数为46kg/m²）接受了胃起搏治疗。在植入胃起搏器前1个月、植入后1个月以及电刺激激活后6个月，研究了外周血中胃饥饿素的水平。在禁食12小时后以及进食低能量餐（1130千焦[270千卡]）后采集血样。每月对患者进行生命体征和体重水平的随访。经过6个月的治疗，胃起搏导致平均体重显著减轻10.4kg或4.4个体重指数单位。治疗期间未观察到负面副作用或并发症。在所有就诊时，胃饥饿素水平均因食物摄入而显著下降。起搏器激活后，胃饥饿素水平与激活前相比显著升高（P<0.01）。体重减轻与胃饥饿素水平升高显著相关（R=0.69，P<0.05）。胃起搏是治疗病态肥胖的一种有前景的疗法。有人提出，胃起搏后胃饥饿素增加是对负能量平衡的一种适应，在体重减轻或体重维持中没有因果作用。
