Mathus-Vliegen Elisabeth, Spångeus Anna, Walter Susanna, Ericson Ann-Charlott
Department of Gastroenterology and Hepatology Academic Medical Centre (AMC) University of Amsterdam Amsterdam the Netherlands.
Department of Health, Medicine and Caring Sciences Division of Diagnostics and Specialist Medicine Linköping University Linköping Sweden.
Obes Sci Pract. 2021 Jan 13;7(2):199-207. doi: 10.1002/osp4.478. eCollection 2021 Apr.
The mechanism of action of intragastric balloons in the treatment of obesity is not fully understood. One of the hypotheses is that balloons might have an effect on the fundus, the area of ghrelin production.
Participants were randomized to a 13-week period of sham or balloon treatment followed by a 13-week period of balloon therapy in everyone. Blood samples for ghrelin levels were taken in the fasting state and after a breakfast at the start, after 13 and 26 weeks. Biopsies for ghrelin cell immunohistochemistry were taken from the fundus at endoscopy.
Seven participants entered the balloon-balloon (BB) group and 11 the sham-balloon (SB) group. Despite a considerable weight loss, a median -17.9 kg (interquartile ranges -23.8 to -0.5) in the BB group and -18.3 kg (-22.7 to -14.7) in the SB group, fasting ghrelin and meal-induced ghrelin response did not change. In the SB group, the number of ghrelin cells increased significantly ( 0.001) from 110.6 (83.6-118.9) to 160.2 (128.5-223.0) while on sham treatment and returned to initial levels, 116.3 (91.7-146.9) ( 0.001), when they received their first balloon. No significant changes in ghrelin cell numbers were observed in the BB group.
In participants without a balloon, weight loss induced an increase in ghrelin cell numbers in the fundus, which was annulled by the subsequent placement of a balloon. The effect of a balloon might be explained by effects on ghrelin cell numbers or ghrelin cell activity.
胃内球囊治疗肥胖症的作用机制尚未完全明确。其中一种假说是球囊可能对胃底产生影响，而胃底是胃饥饿素产生的部位。
参与者被随机分为两组，一组接受为期13周的假治疗，随后所有人再接受为期13周的球囊治疗；另一组直接接受为期13周的球囊治疗。在研究开始时、13周和26周后，分别于空腹状态及早餐后采集血液样本检测胃饥饿素水平。在内镜检查时从胃底取组织样本进行胃饥饿素细胞免疫组化分析。
7名参与者进入球囊-球囊（BB）组，11名进入假-球囊（SB）组。尽管体重显著减轻，BB组中位数减重17.9千克（四分位间距为-23.8至-0.5），SB组减重18.3千克（-22.7至-14.7），但空腹及餐后胃饥饿素反应均未改变。在SB组，接受假治疗时胃饥饿素细胞数量从110.6（83.6 - 118.9）显著增加（P<0.001）至160.2（128.5 - 223.0），而在接受首个球囊治疗后又恢复至初始水平，即116.3（91.7 - 146.9）（P<0.001）。BB组胃饥饿素细胞数量未观察到显著变化。
未放置球囊的参与者体重减轻会导致胃底胃饥饿素细胞数量增加，而随后放置球囊可消除这种增加。球囊的作用可能是通过对胃饥饿素细胞数量或胃饥饿素细胞活性产生影响来解释。
