Weight Loss and Changes in Salivary Ghrelin and Adiponectin: Comparison Between Sleeve Gastrectomy and Roux-en-Y Gastric Bypass and Gastric Banding
Weight Loss and Changes in Salivary Ghrelin and Adiponectin: Comparison Between Sleeve Gastrectomy and Roux-en-Y Gastric Bypass and Gastric Banding
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DOI：
10.1007/s11695-011-0374-5
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发表时间：
2011-05-01
期刊：
影响因子：
2.9
通讯作者：
Wolff, Stephanie
中科院分区：
文献类型：
--
作者：
Benedix, Frank;Westphal, Sabine;Wolff, Stephanie
体重减轻与脂联素水平升高有关，与限制性手术相比，Roux-en-Y胃旁路手术(RYGB)后观察到的增加更大。然而，目前还没有关于腹腔镜袖状胃切除术(LSG)后脂联素变化的数据。据报道，Ghrelin也是由唾液腺产生的。目前还没有关于减肥手术后体重变化的数据。本研究检测了43名接受三种不同类型减肥手术的病态肥胖者的体重减轻、唾液生长素和高分子脂联素水平。我们发现，术后12个月，LSG的体重减轻效果优于腹腔镜可调胃束扎术(LAGB)，与RYGB相当。虽然三种手术后血糖下降相似，但只有LSG和RYGB患者的空腹胰岛素持续下降。空腹和餐后唾液Ghrelin的变化在所有三种方法之间差异很大，与文献报道的血清Ghrelin的变化没有相似之处。LSG治疗后HMW脂联素显著升高，这种增加比LAGB患者更显著，与RYGB患者几乎相同。短期内，LSG患者的体重下降与RYGB患者相当。LSG和RYGB术后HMW脂联素的变化相似，这可能进一步有助于LSG术后的成功。此外，本研究的结果支持这样一种假设，即无论营养状况和体重减轻与否，唾液腺中都会自主产生Ghrelin。
Weight loss is associated with increased levels of adiponectin with a greater increase observed following Roux-en-Y gastric bypass (RYGB) compared to restrictive procedures. However, currently there are no data on changes in adiponectin following laparoscopic sleeve gastrectomy (LSG). Ghrelin was reported to be also produced by the salivary glands. There are also no data available regarding its changes following bariatric surgery.The present study examined weight loss, and salivary ghrelin and HMW adiponectin levels in 43 morbidly obese subjects undergoing three different types of bariatric surgery.We found that weight loss following LSG is superior to laparoscopic adjustable gastric banding (LAGB) and comparable to RYGB at 12 months after surgery. Although blood glucose decreased similarly following all three procedures, fasting insulin continuously declined only in LSG and RYGB patients. Changes in both fasting and postprandial salivary ghrelin greatly varied between all three procedures with no similarities to changes in serum ghrelin reported in the literature. HMW adiponectin significantly increased following LSG, and this increase was more marked than in LAGB patients and almost identical compared to RYGB.Weight loss following LSG is comparable to RYGB in the short term. Changes in HMW adiponectin are comparable following LSG and RYGB which may further contribute to the successful results after LSG. Furthermore, the results of the present study support the hypothesis that there is an autonomous production of ghrelin in salivary glands irrespective of nutritional status and weight loss.