Abdemur Abraham, Slone Johnathan, Berho Mariana, Gianos Melissa, Szomstein Samuel, Rosenthal Raul J
Cleveland Clinic Florida, Weston, FL.
Surg Laparosc Endosc Percutan Tech. 2014 Apr;24(2):122-6. doi: 10.1097/SLE.0b013e318290167a.
The role of the hormone ghrelin in the pathogenesis of morbid obesity is unclear. Researchers have identified its involvement in multifunctional activities that include appetite regulation, intestinal motility, release of growth hormone, and cell proliferation. The purpose of this study is to investigate and distinguish a pattern, if present, in ghrelin-producing cells and to record their distribution and quantity in a heterogenic morbidly obese population.
The Bariatric & Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, FL.
Thirty-six patients who underwent sleeve gastrectomy for morbid obesity were evaluated for number and distribution of gastric ghrelin. Sections of fundus, body, and antrum were evaluated by using a ghrelin antibody staining technique. The gross specimens were divided into the following 3 zones: (1) fundus; (2) body; and (3) antrum. Three sections were then submitted from each zone. The ghrelin cells were counted using an image analyzer (MetaMorph; Universal Imaging Corporation, Downingtown, PA) after staining the blocks with antighrelin antibody. Counting ghrelin cells was standardized, and for each section 10 high-power fields were examined at ×4000. Our statistical analysis entailed a Student t test to compare the number of cells by age, sex, race, diabetic/nondiabetic, and body mass index. A P-value <0.05 was considered statistically significant.
Thirty-six patients (female 20/male 16) were studied. The average age of these patients was 45.6 (18 to 71) years. Race distribution was as follows: whites, 50% (18); African American, 13.9% (5); and Hispanic, 36.1% (13). Patients with diabetes comprised 13.9% of the cohort (5). Average body mass index was 44.9 kg/m (31 to 70). Significant differences in ghrelin cell distribution were found when comparing gastric anatomy location. Ghrelin cells were significantly more abundant in the gastric fundus when compared with the body and the antrum. Quantities of cells in the antrum were significantly higher in the Hispanic population (P=0.0054). No significant differences among other groups were observed.
In conclusion, ghrelin-producing cells seem to be more abundant in the fundus of morbidly obese patients. No significant differences were found in terms of number of cells by age, sex, presence of diabetes, or body mass index. There was an incidental finding of a higher concentration of these cells located in the antrum of the Hispanic population when compared with the white cohort.
激素胃饥饿素在病态肥胖发病机制中的作用尚不清楚。研究人员已确定其参与多种功能活动，包括食欲调节、肠道蠕动、生长激素释放和细胞增殖。本研究的目的是调查并区分胃饥饿素产生细胞中是否存在某种模式，并记录其在异质性病态肥胖人群中的分布和数量。
佛罗里达州韦斯顿市克利夫兰诊所佛罗里达分院微创外科减重与代谢研究所。
对36例因病态肥胖接受袖状胃切除术的患者进行胃饥饿素数量和分布评估。采用胃饥饿素抗体染色技术评估胃底、胃体和胃窦切片。大体标本分为以下3个区域：（1）胃底；（2）胃体；（3）胃窦。然后从每个区域提交3个切片。在用抗胃饥饿素抗体对切片进行染色后，使用图像分析仪（MetaMorph；通用成像公司，宾夕法尼亚州唐宁敦）对胃饥饿素细胞进行计数。胃饥饿素细胞计数采用标准化方法，每个切片在×4000下检查10个高倍视野。我们的统计分析采用学生t检验，以比较不同年龄、性别、种族、糖尿病/非糖尿病患者以及体重指数患者的细胞数量。P值<0.05被认为具有统计学意义。
研究了36例患者（女性20例/男性16例）。这些患者的平均年龄为45.6岁（18至71岁）。种族分布如下：白人占50%（18例）；非裔美国人占13.9%（5例）；西班牙裔占36.1%（13例）。糖尿病患者占队列的13.9%（5例）。平均体重指数为44.9kg/m²（31至70）。比较胃的解剖位置时，发现胃饥饿素细胞分布存在显著差异。与胃体和胃窦相比，胃底的胃饥饿素细胞明显更多。西班牙裔人群胃窦中的细胞数量显著更高（P = 0.0054）。其他组之间未观察到显著差异。
总之，病态肥胖患者胃底中产生胃饥饿素的细胞似乎更多。在细胞数量方面，未发现年龄、性别、是否患有糖尿病或体重指数有显著差异。偶然发现，与白人队列相比，西班牙裔人群胃窦中这些细胞的浓度更高。
