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Eating behavior in laparoscopic sleeve gastrectomy: Correlation between plasma ghrelin levels and hunger

Essverhalten nach laparoskopischer "Sleeve Gastrectomy" – Korrelationen zwischen Plasma-Ghrelin-Spiegeln und Hungerempfinden

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Zusammenfassung

GRUNDLAGEN: Bariatrische Operationsverfahren wie das Magenband, VGB und Magenbypass haben nachgewiesenermaßen Einfluss auf das postoperative Essverhalten. Nachdem die laparoskopische "Sleeve gastrectomy" (LSG) zu verringerten Ghrelin-Spiegeln führt, ist eine Reduktion im Hungerempfinden zu erwarten. Ziel dieser Studie war es, den Einfluss der LSG auf das Essverhalten in Korrelation Plasma-Ghrelin-Spiegeln zu bestimmen. METHODIK: In dieser prospektiven Studie von 15 morbid adipösen LSG-Patienten wurde die deutsche Version des "Self-report Three-Factor Eating Questionnaire" (TFEQ) vor der Operation und 6 Monate postoperativ angewandt, um den Einfluss der LSG auf die drei Dimensionen des Essverhaltens: Kontrolle, Irritierbarkeit und Hungerempfinden zu bestimmen. In einer Untergruppe von 7 Patienten wurde die Korrelation zwischen Plasma-Ghrelin-Spiegeln und dem Hungerempfinden untersucht. ERGEBNISSE: LSG führte zu einer Zunahme in der kognitiven Einschränkung und zu einer reduzierten Kontrolle, Irritierbarkeit. Weiters wurde eine signifikante Reduktion im Hungerempfinden nachgewiesen, welche ebenfalls mit den Ghrelin-Spiegeln korrelierte (r = 0.834, p = 0.01). SCHLUSSFOLGERUNGEN: LSG führt zu einem reduzierten Hungerempfinden, welches mit den ebenfalls verringerten Plasma-Ghrelin-Spiegeln korreliert. Diese Effekte können zu dem exzellenten Gewichtsverlust nach LSG beitragen.

Summary

BACKGROUND: Bariatric procedures like gastric banding, vertically banded gastroplasty and Roux-en-Y gastric bypass have impacted on the postoperative eating behavior. Since laparoscopic sleeve gastrectomy (LSG) leads to decreased plasma ghrelin levels, a reduced sensation of hunger following surgery is expected. The aim of this study was to assess the impact of LSG on the eating behavior in correlation with plasma ghrelin levels. METHODS: This prospective study was carried out in 15 morbidly obese patients who underwent LSG. The German version of the self-report Three-Factor Eating Questionnaire (TFEQ) was applied preoperatively and at six months following surgery to assess the impact of LSG on the three dimensions of eating behavior: restraint, disinhibition and hunger. The correlation between plasma ghrelin levels and the sensation of hunger was assessed in a subset of seven patients. RESULTS: Following LSG, increased cognitive restraint and decreased disinhibition of eating were found. Furthermore, a significant decrease in hunger was observed with a significant correlation (r = 0.834, p = 0.01) between circulating plasma ghrelin levels and hunger scores. CONCLUSIONS: Following LSG, a high correlation between decreased ghrelin levels and the reduced sensation of hunger was found. This may contribute to the excellent weight loss observed following laparoscopic sleeve gastrectomy.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, University of Vienna, Vienna, Austria

    F. B. Langer, A. Bohdjalian, S. Shakeri-Manesch, J. Zacherl & G. Prager

  2. Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria

    R. Riener, K. Schindler & B. Ludvik

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  1. F. B. Langer
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  2. A. Bohdjalian
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  3. S. Shakeri-Manesch
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  5. R. Riener
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  7. B. Ludvik
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  8. G. Prager
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Correspondence to G. Prager.

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Langer, F., Bohdjalian, A., Shakeri-Manesch, S. et al. Eating behavior in laparoscopic sleeve gastrectomy: Correlation between plasma ghrelin levels and hunger. Eur Surg 40, 120–124 (2008). https://doi.org/10.1007/s10353-008-0406-0

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  • DOI: https://doi.org/10.1007/s10353-008-0406-0

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