Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, 34303 Cerrahpasa, Istanbul, Turkey.
Obes Surg. 2012 Feb;22(2):299-305. doi: 10.1007/s11695-011-0498-7.
It has been proposed that laparoscopic adjustable gastric banding (LAGB) procedure might play a role in modulation of fundic ghrelin production. To test this hypothesis, we examined plasma and tissue concentrations of acylated ghrelin in morbidly obese patients before and 6 months after LAGB. Baseline levels of acylated ghrelin in morbidly obese patients were also compared with those in age-matched, healthy, non-obese controls.
We studied 21 patients who had been operated on for morbid obesity (M/F = 9/12, BMI = 49.3 ± 5.3 kg/m(2)) and 16 healthy, non-obese persons (M/F = 7/9, BMI = 23.0 ± 1.7 kg/m(2)). Fasting blood samples were collected once from the non-obese controls as well as the morbidly obese patients before and 6 months after the LAGB. The morbidly obese patients and their respective controls underwent gastroscopy for fundic biopsy. The plasma and fundic acylated ghrelin levels were evaluated in these groups by enzyme-linked immunosorbent assay.
The plasma and fundic acylated ghrelin concentrations were significantly lower in obese patients than in non-obese controls (2.8 ± 1.0 ng/ml, 727 ± 171.7 ng/g tissue, respectively; p = 0.000). These parameters were significantly increased in morbidly obese patients 6 months after LAGB (4.1 ± 1.2 ng/ml and p = 0.001; 999 ± 292.1 ng/g tissue and p = 0.003, respectively).
We showed that fundic production of acylated ghrelin was significantly increased in morbidly obese patients 6 months after LAGB. Moreover, the weight loss after LAGB occurred in spite of the significant increase in the plasma and fundic acylated ghrelin levels. The potential role of ghrelin as being responsible for the weight loss after bariatric surgery needs to be elucidated in further studies.
有人提出腹腔镜可调节胃束带术（LAGB）可能在调节胃底 ghrelin 产生方面发挥作用。为了验证这一假说，我们检测了肥胖症患者在 LAGB 术前和术后 6 个月时的血浆和组织酰化 ghrelin 浓度。同时，我们还将肥胖症患者的基础酰化 ghrelin 水平与年龄匹配的健康非肥胖对照组进行了比较。
我们研究了 21 名接受肥胖症手术的患者（男/女=9/12，BMI=49.3±5.3kg/m2）和 16 名健康非肥胖者（男/女=7/9，BMI=23.0±1.7kg/m2）。我们从非肥胖对照组以及肥胖症患者中采集空腹血样，分别在 LAGB 术前和术后 6 个月进行。肥胖症患者和他们各自的对照组都接受了胃镜检查，进行胃底活检。通过酶联免疫吸附试验（ELISA）评估这些组的血浆和胃底酰化 ghrelin 水平。
肥胖症患者的血浆和胃底酰化 ghrelin 浓度明显低于非肥胖对照组（分别为 2.8±1.0ng/ml 和 727±171.7ng/g 组织；p=0.000）。LAGB 术后 6 个月，肥胖症患者的这些参数显著升高（分别为 4.1±1.2ng/ml 和 p=0.001；999±292.1ng/g 组织和 p=0.003）。
我们表明，LAGB 术后 6 个月，肥胖症患者的胃底酰化 ghrelin 产生显著增加。此外，尽管血浆和胃底酰化 ghrelin 水平显著升高，但 LAGB 后仍出现体重减轻。在进一步的研究中，需要阐明 ghrelin 在减肥手术后减轻体重中的潜在作用。
