Roth Christian L, Reinehr Thomas, Schernthaner Gerit-Holger, Kopp Hans-Peter, Kriwanek Stefan, Schernthaner Guntram
Seattle Children's Hospital Research Institute, 1900 Ninth Avenue, Seattle, WA, 98101, USA.
Obes Surg. 2009 Jan;19(1):29-35. doi: 10.1007/s11695-008-9568-x. Epub 2008 Jun 3.
Ghrelin and obestatin are derived from the same gene but have different effects: Ghrelin stimulates appetite, and previous-albeit inconsistent-data show that obestatin may be involved in satiety. The present study was designed to test the hypothesis that Roux-en-Y gastric bypass (RYGB) surgery and/or the weight loss that reliably results from this procedure would alter levels of ghrelin and obestatin and ghrelin/obestatin ratios in a cohort of morbidly obese women.
This is a longitudinal follow-up study in 18 morbidly obese women (mean weight 131.2 kg, mean body mass index [BMI] 47.4). Clinical parameters and fasting serum concentrations of ghrelin, obestatin, triglycerides, low-density lipoprotein cholesterol, glucose, and insulin were measured before and 2 years after RYGB surgery, which was associated with body weight reductions of 41.5 +/- 11.6 kg (mean 62.5% excess weight loss).
Ghrelin concentrations (-12%, p = 0.022) and ghrelin/obestatin ratios (-14%, p = 0.017) were lower after surgery than before, while obestatin levels did not change. Changes in ghrelin concentrations correlated with changes in insulin levels (r = 0.45, p = 0.011). Most cardiovascular risk factors studied improved postsurgically (p < 0.01).
In contrast to previous weight loss studies involving gastric banding, ghrelin levels decreased and obestatin levels remained stable after massive weight loss in long-term follow-up. The favorable gastrointestinal hormone profiles observed are likely to contribute to the long-term weight loss success rate attributed to RYGB.
胃饥饿素和肥胖抑制素源自同一基因，但作用不同：胃饥饿素刺激食欲，而此前虽不一致但有数据表明肥胖抑制素可能参与饱腹感调节。本研究旨在验证以下假设：Roux-en-Y胃旁路术（RYGB）及该手术可靠导致的体重减轻会改变一组病态肥胖女性体内胃饥饿素、肥胖抑制素水平及胃饥饿素/肥胖抑制素比值。
这是一项针对18名病态肥胖女性（平均体重131.2千克，平均体重指数[BMI]47.4）的纵向随访研究。在RYGB手术前及术后2年测量临床参数以及空腹血清中胃饥饿素、肥胖抑制素、甘油三酯、低密度脂蛋白胆固醇、葡萄糖和胰岛素的浓度，该手术使体重减轻了41.5±11.6千克（平均额外体重减轻62.5%）。
术后胃饥饿素浓度（-12%，p = 0.022）和胃饥饿素/肥胖抑制素比值（-14%，p = 0.017）低于术前，而肥胖抑制素水平未改变。胃饥饿素浓度变化与胰岛素水平变化相关（r = 0.45，p = 0.011）。术后大多数研究的心血管危险因素得到改善（p < 0.01）。
与先前涉及胃束带术的体重减轻研究不同，在长期随访中，大量体重减轻后胃饥饿素水平下降，肥胖抑制素水平保持稳定。观察到的有利胃肠激素谱可能有助于RYGB手术取得长期减肥成功率。
