Postoperative ghrelin levels and delayed recovery from body weight loss after distal or total gastrectomy
Postoperative ghrelin levels and delayed recovery from body weight loss after distal or total gastrectomy
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DOI：
10.1016/j.jss.2005.08.003
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发表时间：
2006-01-01
影响因子：
2.2
通讯作者：
Imaoka, S
中科院分区：
文献类型：
--
作者：
Takachi, K;Doki, Y;Imaoka, S
背景体重减轻是胃切除术后常见但最严重的后遗症之一。胃饥饿素是一种新型的胃激素，通过食欲控制和代谢反应上调体重，似乎受胃手术的影响。对13例住院患者术后第3天和第7天血清ghrelin的变化进行了评价。对64例术前4.6个月~ 136个月（平均41个月）行全胃切除术（TG：26例）或远端胃切除术（DG：38例）患者的血清ghrelin和leptin水平与术后体重的关系进行了研究。TG后血清ghrelin立即大幅下降至术前水平的12%（第3天和第7天），而DG后下降不太显著，分别为39%（第3天）和56%（第7天）。在门诊患者中，与对照组相比，TG后的血清ghrelin水平非常低（18.6 fmol/mL vs 92.1 fmol/mL，P < 0.0001），与手术后的时间无关，而DG后的水平恢复并与对照组相当（73.4 fmol/mL，P = 0.355）。TG患者的体重减轻比DG患者更明显，显示体重指数（Delta BMI）术后减少-3.940 vs-1.949（P < 0.0001）。TG和DG患者血清瘦素水平与BMI均呈显著相关，TG患者血清瘦素水平明显低于DG患者（800 pg/mL vs 1158 pg/mL，P = 0.236）。全胃切除术后常出现血清ghrelin和体重持续下降。需要进一步的研究，以是否胃饥饿素管理可以改善这些患者的体重水平。(c)2006年爱思唯尔公司All rights reserved.
Background. Body weight loss is a common but one of the most serious sequelae after gastrectomy. Ghrelin, a novel gastric hormone that up-regulates body weight through appetite control and metabolic reaction, seems to be affected by gastric surgery.Patients and methods. Early postoperative alteration of serum ghrelin was evaluated at days 3 and 7 after gastrectomy for 13 hospital patients. In 64 outpatients who had previously undergone total gastrectomy (TG: 26 patients) or distal gastrectomy (DG: 38 patients) 4.6 months to 136 months (average, 41 months) earlier, the association between their serum ghrelin and leptin levels and postoperative body weight was investigated.Results. Serum ghrelin declined immediately and greatly after TG to 12% of the preoperative level (day 3 and day 7), whereas the decline was less significant after DG at 39% (day 3) and 56% (day 7). In outpatients, serum ghrelin after TG was very low compared with the control (18.6 fmol/mL versus 92.1 fmol/mL, P < 0.0001), irrespective of the period after surgery, whereas the level after DG recovered and was equivalent to the control (73.4 fmol/mL, P = 0.355). Body weight loss was more apparent in TG patients than in DG patients, showing postoperative reduction of body mass index (Delta BMI) -3.940 versus -1.949 (P < 0.0001). Serum leptin concentration, reflecting the systemic fat volume, significantly correlated with BMI in both TG and DG patients, and tended to be lower in TG patients than in DG patients (800 pg/mL versus 1158 pg/mL, P = 0.236).Conclusion. Persistent decline of serum ghrelin and body weight was observed commonly after total gastrectomy. Further study is needed as to whether or not ghrelin administration can improve the body weight level for these patients. (c) 2006 Elsevier Inc. All rights reserved.