Department of Endocrinology, Copenhagen University Hospital, Hvidovre, Denmark.
Department of Biomedical Sciences, SUND, University of Copenhagen, Copenhagen, Denmark.
Am J Physiol Endocrinol Metab. 2024 Sep 1;327(3):E396-E410. doi: 10.1152/ajpendo.00177.2024. Epub 2024 Jul 31.
Ghrelin is an appetite-stimulating hormone secreted from the gastric mucosa in the fasting state, and secretion decreases in response to food intake. After sleeve gastrectomy (SG), plasma concentrations of ghrelin decrease markedly. Whether this affects appetite and glucose tolerance postoperatively is unknown. We investigated the effects of ghrelin infusion on appetite and glucose tolerance in individuals with obesity before and 3 mo after SG. Twelve participants scheduled for SG were included. Before and 3 mo after surgery, a mixed-meal test followed by an ad libitum meal test was performed with concomitant infusions of acyl-ghrelin (1 pmol/kg/min) or placebo. Infusions began 60 min before meal intake to reach a steady state before the mixed-meal and were continued throughout the study day. Two additional experimental days with 0.25 pmol/kg/min and 10 pmol/kg/min of acyl-ghrelin infusions were conducted 3 mo after surgery. Both before and after SG, postprandial glucose concentrations increased dose dependently during ghrelin infusions compared with placebo. Ghrelin infusions inhibited basal and postprandial insulin secretion rates, resulting in lowered measures of β-cell function, but no effect on insulin sensitivity was seen. Ad libitum meal intake was unaffected by the administration of ghrelin. In conclusion, ghrelin infusion increases postprandial plasma glucose concentrations and impairs β-cell function before and after SG but has no effect on ad libitum meal intake. We speculate that the lower concentration of ghrelin after SG may impact glucose metabolism following this procedure. Ghrelin's effect on glucose tolerance and food intake following sleeve gastrectomy (SG) was evaluated. Acyl-ghrelin was infused during a mixed-meal and ad libitum meals before and 3 mo after surgery. Postprandial glucose concentrations increased during ghrelin infusions, both before and after surgery, while insulin production was inhibited. However, ad libitum meal intake did not differ during ghrelin administration compared with placebo. The decreased ghrelin concentration following SG may contribute to the glycemic control after surgery.
胃饥饿素是一种在空腹状态下从胃黏膜分泌的食欲刺激激素，其分泌会随着食物摄入而减少。袖状胃切除术后（SG），血浆胃饥饿素浓度明显降低。术后胃饥饿素的变化是否会影响食欲和葡萄糖耐量尚不清楚。我们研究了胃饥饿素输注对肥胖个体术前和 SG 术后 3 个月时食欲和葡萄糖耐量的影响。纳入了 12 名计划接受 SG 的患者。手术前和术后 3 个月，进行混合餐试验和自由进食试验，并同时输注酰基胃饥饿素（1 pmol/kg/min）或安慰剂。输注在餐前 60 分钟开始，以便在混合餐和整个研究日达到稳定状态。术后 3 个月还进行了另外两天的实验，输注 0.25 pmol/kg/min 和 10 pmol/kg/min 的酰基胃饥饿素。与安慰剂相比，胃饥饿素输注后餐后血糖浓度呈剂量依赖性增加。胃饥饿素输注抑制了基础和餐后胰岛素分泌率，导致β细胞功能下降，但对胰岛素敏感性没有影响。自由进食量不受胃饥饿素给药的影响。结论：SG 前后，胃饥饿素输注会增加餐后血浆葡萄糖浓度并损害β细胞功能，但对自由进食量没有影响。我们推测 SG 后胃饥饿素浓度降低可能会影响术后的葡萄糖代谢。评估了胃饥饿素对袖状胃切除术后（SG）葡萄糖耐量和饮食摄入的影响。在手术前和术后 3 个月，在混合餐和自由饮食期间输注酰基胃饥饿素。SG 前后，胃饥饿素输注期间餐后血糖浓度增加，而胰岛素分泌受到抑制。然而，与安慰剂相比，在给予胃饥饿素时，自由进食量没有差异。SG 后胃饥饿素浓度降低可能导致术后血糖控制。
