Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy - A prospective, double blind study
Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy - A prospective, double blind study
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DOI：
10.1097/sla.0b013e318156f012
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发表时间：
2008-03-01
影响因子：
9
通讯作者：
Alexandrides, Theodore K.
中科院分区：
文献类型：
--
作者：
Karamanakos, Stavros N.;Vagenas, Konstantinos;Alexandrides, Theodore K.
背景：减肥手术是目前病态肥胖患者最有效的治疗方法，可持续减轻体重。目的：在这项前瞻性双盲研究中，我们的目的是评估和比较腹腔镜Roux-en-Y胃旁路术（LRYGBP）与腹腔镜袖状胃切除术（LSG）对体重、食欲、空腹和餐后生长激素释放肽和肽YY（PYY）水平的影响。方法：随机分组后，16例患者被分配到LRYGBP组和16例LSG组。在术后第1、3、6和12个月对患者进行重新评估。在禁食过夜后和标准420 keal混合餐后，每组6例患者采集血样。结果：两种方法治疗后体重和体重指数（BMI）均明显下降（P < 0.0001），且无明显变化. LSG后6个月（55.5% +/- 7.6% vs. 50.2% +/-6.5%，P = 0.04）和12个月（69.7% +/- 14.6% vs. 60.5% +/-10.7%，[P = 0.05]）的体重过度减轻更大。LRYGBP后，空腹ghrelin水平与基线相比没有显著变化（P = 0.19），试验餐后也没有显著下降。另一方面，LSG后空腹ghrelin水平显著降低（P < 0.0001），餐后明显抑制。两种手术后空腹PYY水平均升高（P
Background: Bariatric surgery is currently the most effective treatment in morbidly obese patients, leading to durable weight loss. Objective: In this prospective double blind study, we aim to evaluate and compare the effects of laparoscopic Roux-en-Y gastric bypass (LRYGBP) with laparoscopic sleeve gastrectomy (LSG) on body weight, appetite, fasting, and postprandial ghrelin and peptide-YY (PYY) levels. Methods: After randomization, 16 patients were assigned to LRYGBP and 16 patients to LSG. Patients were reevaluated on the 1st, 3rd, 6th, and 12th postoperative month. Blood samples were collected after an overnight fast and in 6 patients in each group after a standard 420 keal mixed meal. Results: Body weight and body mass index (BMI) decreased markedly (P < 0.0001) and comparably after either procedure. Excess weight loss was greater after LSG at 6 months (55.5% +/- 7.6% vs. 50.2% +/- 6.5%, P = 0.04) and 12 months (69.7% +/- 14.6% vs. 60.5% +/- 10.7%, [P = 0.05]). After LRYGBP fasting ghrelin levels did not change significantly compared with baseline (P = 0.19) and did not decrease significantly after the test meal. On the other hand, LSG was followed by a marked reduction in fasting ghrelin levels (P < 0.0001) and a significant suppression after the meal. Fasting PYY levels increased after either surgical procedure (P