Sleeve gastrectomy and gastric banding: Effects on plasma ghrelin levels
Sleeve gastrectomy and gastric banding: Effects on plasma ghrelin levels
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DOI：
10.1381/0960892054621125
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发表时间：
2005-08-01
期刊：
影响因子：
2.9
通讯作者：
Prager, G
中科院分区：
文献类型：
--
作者：
Langer, FB;Hoda, MAR;Prager, G
背景资料：据报道，胃束带术、Roux-en-Y胃旁路术和胆胰分流术后血浆ghrelin水平发生了不同变化。方法：本前瞻性研究比较了20例腹腔镜袖状胃切除术（LSG）和腹腔镜可调节胃束带术（LAGB）后血浆ghrelin水平和体重减轻情况。结果：接受LSG的患者（n=10）在第1天血浆ghrelin与术前值相比显著降低（35.8 ± 12.3 fmol/ml vs 109.6 ± 32.6 fmol/ml，P=0.005）。术后1个月和6个月，血浆ghrelin保持较低水平和稳定。相比之下，LAGB后患者（n=10）第1天血浆ghrelin无变化（71.8 +/- 35.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml，P=0.441）。术后1个月（101.9 +/- 30.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml，P=0.028）和6个月（104.9 +/- 51.1 fmol/ml vs 73.7 +/- 24.8 fmol/ml，P=0.012）观察到血浆ghrelin水平较术前水平升高。LSG组的平均额外体重减轻率较高，（30 +/- 13% vs 17 +/-7%，P=0.005）和6个月（61 +/- 16% vs 29 +/-11%，P=0.001）。结论：由于切除胃底（人生长素释放肽产生的主要区域），生长素释放肽在LSG后显著减少，但在LAGB后没有。这种复位在术后6个月随访时保持稳定，这可能有助于与LAGB相比具有更好的上级体重减轻。
Background: Different changes of plasma ghrelin levels have been reported following gastric banding, Roux-en-Y gastric bypass, and biliopancreatic diversion.Methods: This prospective study compares plasma ghrelin levels and weight loss following laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) in 20 patients.Results: Patients who underwent LSG (n=10) showed a significant decrease of plasma ghrelin at day 1 compared to preoperative values (35.8 +/- 12.3 fmol/ml vs 109.6 +/- 32.6 fmol/ml, P=0.005). Plasma ghrelin remained low and stable at 1 and 6 months postoperatively. In contrast, no change of plasma ghrelin at day 1 (71.8 +/- 35.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.441) was found in patients after LAGB (n=10). Increased plasma ghrelin levels compared with the preoperative levels at 1 (101.9 +/- 30.3 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.028) and 6 months (104.9 +/- 51.1 fmol/ml vs 73.7 +/- 24.8 fmol/ml, P=0.012) after surgery were observed. Mean excess weight loss was higher in the LSG group at 1 (30 +/- 13% vs 17 +/- 7%, P=0.005) and 6 months (61 +/- 16% vs 29 +/- 11%, P=0.001) compared with the LAGB group.Conclusions: As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.