Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Calle de Oña, 28050, Madrid, Spain.
Department of Nutrition and Clinical Diabetes, Hospital Clinico San Carlos, Madrid, Spain.
Obes Surg. 2020 Jul;30(7):2642-2651. doi: 10.1007/s11695-020-04541-0.
ESG reduces gastric lumen similar to LSG and induces significant weight loss. However, the metabolic and physiological alteration after ESG is not fully understood. We aim to study the gastrointestinal hormone changes after ESG and compared it with LSG.
We conducted a prospective pilot study comparing ESG and LSG at two centers in Spain. We administered a standard test meal after an overnight fast, and collected blood samples before and after meal. We measured the levels of ghrelin, GLP-1, peptide-YY, insulin, leptin, and adiponectin. We evaluated the hormone profile and weight changes (%TBWL) at baseline and at 6 months after the procedure.
Twenty-four patients were recruited (ESG-12, LSG-12). The baseline age, sex, BMI, and fasting hormone levels were similar between the groups. At 6-month post-ESG, there was a significant decline in the leptin levels. We found a trend towards a decrease in insulin levels and improvement in insulin secretory pattern. We did not observe any change in fasting ghrelin levels, GLP-1, and PYY. At 6 months, LSG induced a significant reduction in the ghrelin, and leptin levels, and increase in peptide-YY, and adiponectin levels, respectively. A trend towards an increase in GLP-1 level was noted. However, no change in insulin was observed. LSG achieved greater %TBWL (24.4 vs. 13.3, p < 0.001) and significantly change in ghrelin, PYY, and adiponectin levels at 6 months compared to ESG.
ESG induced gut hormone changes differently as compared to LSG. ESG prevented a compensatory rise in ghrelin and promoted beneficial changes in the insulin secretory pattern with weight loss.
ESG 可缩小胃腔，与 LSG 相似，并可显著减轻体重。然而，ESG 后的代谢和生理变化尚不完全清楚。我们旨在研究 ESG 后的胃肠激素变化，并与 LSG 进行比较。
我们在西班牙的两个中心进行了一项前瞻性的初步研究，比较了 ESG 和 LSG。我们在禁食一夜后给予标准试验餐，并在餐前和餐后采集血液样本。我们测量了胃饥饿素、GLP-1、肽 YY、胰岛素、瘦素和脂联素的水平。我们评估了基线和术后 6 个月的激素谱和体重变化（%TBWL）。
共招募了 24 例患者（ESG-12 例，LSG-12 例）。两组的基线年龄、性别、BMI 和空腹激素水平相似。ESG 术后 6 个月，瘦素水平显著下降。我们发现胰岛素水平呈下降趋势，胰岛素分泌模式改善。空腹胃饥饿素水平、GLP-1 和 PYY 无变化。6 个月时，LSG 可显著降低胃饥饿素和瘦素水平，增加肽 YY 和脂联素水平，GLP-1 水平呈上升趋势。然而，胰岛素无变化。LSG 可实现更大的 %TBWL（24.4%比 13.3%，p<0.001），并在 6 个月时显著改变胃饥饿素、PYY 和脂联素水平，而 ESG 则无变化。
ESG 引起的肠道激素变化与 LSG 不同。ESG 可防止胃饥饿素的代偿性升高，并促进胰岛素分泌模式的有益变化，从而减轻体重。
