Bariatric Surgery, Gastric Stimulation: Metabolic Effects

描述（由申请人提供）： 这项提案的长期目标是检查可能调节减肥手术和植入式胃刺激（IGS）引起的体重减轻和体重维持的激素机制。 特别关注肠道-中枢神经系统轴的激素，其参与食欲调节、肠道运动、能量分配和能量ZV消耗。 目的一是：a）比较空腹和餐后ghrelin浓度的变化在一项长期前瞻性研究中，在Roux-en-Y胃旁路术（GBP）和胃束带术（BND）之前和之后测定总YY（总的和辛酰化的）和肽YY（PYY），并确定这些变化是否与饥饿、饱腹感、体重减轻和体重维持的程度相关; B）表征和;使用高效液相色谱法测定PYY的两种分子形式PYY（1 -36）和PYY（3-36）的空腹和餐后浓度，其与GBP和BND后体重和体重减轻有关;和c）确定每单位脂肪量的血浆瘦素和身体组成，特别是内脏脂肪量，在GBP和BND手术后体重减轻的个体中使用核磁共振成像目的比较两组患者的代谢和神经内分泌变化.本研究的目的是：a）通过频繁采血进行静脉葡萄糖耐量试验，确定前肠在介导胰岛素敏感性方面的作用;和B）比较这三种减肥方式对甲状腺和生长激素轴的影响。目标三的重点是阐明IGS系统诱导的体重减轻的可能激素机制，IGS系统是目前正在研究的一种新的减肥疗法。最终目标是利用这些研究的信息开发比减肥手术侵入性更小，比目前药物治疗更有效的肥胖治疗方法。

DESCRIPTION (provided by applicant): The long-term objectives of this proposal are to examine hormonal mechanisms that may regulate weight loss and weight maintenance induced by bariatric surgery and implantable gastric stimulation (IGS). Particular focus is on hormones of the gut-central nervous system axis that are involved in appetite regulation, gut motility, energy partitioning and energy ZV expenditure. The objectives of Aim One are: a) to compare the changes in both fasting and post-prandial concentrations of ghrelin (total and octanoylated) and peptide YY (PYY) before and after Roux-en-Y gastric bypass (GBP) and gastric banding (BND) in a long-term prospective study and determine if these changes correlate with hunger, satiety, degree of weight loss weight maintenance; b) to characterize and; the fasting and post-prandial concentrations using high performance liquid chromatography of the two molecular forms of PYY, PYY(l-36) and PYY(3-36), in relation to body weight and weight reduction after GBP and BND; and c) to determine if there are differences in plasma leptin per unit fat mass and body composition, particularly visceral fat mass, using nuclear magnetic resonance imaging in weight-reduced individuals after GBP and BND procedures. Aim Two compares metabolic and neuroendocrine changes in individuals GBP and END. The purposes of this who have lost an equivalent amount of weight by calorie restriction, Aim are: a) to determine the role of the foregut in mediating insulin sensitivity through the use of intravenous glucose tolerance tests with frequent blood sampling; and b) compare the effects on thyroid and growth hormone axes with these three weight loss modalities. The focus of Aim Three is to elucidate possible hormonal mechanisms for weight loss induced by the IGS system, a new modality of weight loss therapy currently under investigation. The ultimate goal is to use information from these studies for the development of obesity treatments that are less invasive than bariatric surgery and more effective than current pharmacotherapy.