Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands,
Obes Surg. 2014 Jan;24(1):85-94. doi: 10.1007/s11695-013-1053-5.
Intragastric balloons may be an option for obese patients with weight loss failure. Its mode of action remains enigmatic. We hypothesised depressed fasting ghrelin concentrations and enhanced meal suppression of ghrelin secretion by the gastric fundus through balloon contact and balloon-induced delayed gastric emptying.
Patients were randomised to a 13-week period of sham or balloon treatment, followed by a 13-week period of balloon treatment in everyone. Blood samples for ghrelin measurement were taken in the fasting state and every 15 min for 1 h after a breakfast meal at the start, after 13 weeks and after 26 weeks. Patients filled out scales to assess satiety and kept a food diary.
Forty obese patients (BMI 43.1 kg/m(2)) participated. At the start, fasting ghrelin values were low with a blunted ghrelin response to a test meal. The presence of a balloon had no influence on fasting or meal-suppressed ghrelin concentrations. Despite a weight loss of 10 % after 13 weeks and 15 % after 26 weeks, fasting ghrelin concentrations did not change; neither did the ghrelin response to a meal. No relation was found between ghrelin and insulin, satiety, intermeal interval, the number of meals or subsequent energy intake. Ghrelin concentrations were more suppressed with greater weight loss or with balloons located in the fundus.
Ghrelin concentrations did not change by balloon treatment after 13 and 26 weeks and, unexpectedly, did not rise despite substantial weight loss and negative energy balance. This suppression might be of benefit in the maintenance of weight loss but could not be ascribed to the balloon treatment.
胃内球囊可能是减肥失败的肥胖患者的一种选择。其作用机制仍然难以捉摸。我们假设空腹胃饥饿素浓度降低，并且胃底通过球囊接触和球囊引起的胃排空延迟来增强对胃饥饿素分泌的餐后抑制。
患者被随机分为假治疗或球囊治疗 13 周，然后所有人都接受球囊治疗 13 周。在开始时、13 周后和 26 周后，在空腹状态和早餐后每 15 分钟抽取一次血样测量胃饥饿素。患者填写量表评估饱腹感并保留食物日记。
40 名肥胖患者（BMI 43.1 kg/m²）参与了研究。开始时，空腹胃饥饿素值较低，对测试餐的胃饥饿素反应迟钝。球囊的存在对空腹或餐后抑制的胃饥饿素浓度没有影响。尽管在 13 周和 26 周后体重减轻了 10%和 15%，但空腹胃饥饿素浓度没有变化；餐后胃饥饿素反应也没有变化。胃饥饿素与胰岛素、饱腹感、两餐之间的间隔、用餐次数或随后的能量摄入之间没有关系。随着体重减轻或球囊位于胃底，胃饥饿素浓度的抑制作用更大。
在 13 周和 26 周后，球囊治疗并没有改变胃饥饿素浓度，而且尽管体重明显减轻且处于负能平衡状态，胃饥饿素浓度也没有升高。这种抑制可能有助于维持体重减轻，但不能归因于球囊治疗。
