Ghrelin and Obestatin Levels in Severely Obese Women Before and After Weight Loss After Roux-en-Y Gastric Bypass Surgery
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Ghrelin and obestatin are derived from the same gene but have different effects: Ghrelin stimulates appetite, and previous—albeit inconsistent—data show that obestatin may be involved in satiety. The present study was designed to test the hypothesis that Roux-en-Y gastric bypass (RYGB) surgery and/or the weight loss that reliably results from this procedure would alter levels of ghrelin and obestatin and ghrelin/obestatin ratios in a cohort of morbidly obese women.
This is a longitudinal follow-up study in 18 morbidly obese women (mean weight 131.2 kg, mean body mass index [BMI] 47.4). Clinical parameters and fasting serum concentrations of ghrelin, obestatin, triglycerides, low-density lipoprotein cholesterol, glucose, and insulin were measured before and 2 years after RYGB surgery, which was associated with body weight reductions of 41.5 ± 11.6 kg (mean 62.5% excess weight loss).
Ghrelin concentrations (−12%, p = 0.022) and ghrelin/obestatin ratios (−14%, p = 0.017) were lower after surgery than before, while obestatin levels did not change. Changes in ghrelin concentrations correlated with changes in insulin levels (r = 0.45, p = 0.011). Most cardiovascular risk factors studied improved postsurgically (p < 0.01).
In contrast to previous weight loss studies involving gastric banding, ghrelin levels decreased and obestatin levels remained stable after massive weight loss in long-term follow-up. The favorable gastrointestinal hormone profiles observed are likely to contribute to the long-term weight loss success rate attributed to RYGB.
KeywordsGhrelin Obestatin Gastric bypass Cardiovascular risk factors Obesity Weight loss Roux-en Y gastric bypass
We thank Ms. R. Maslak and Ms. K. Schark-Zimmer, Children’s Hospital University of Bonn, for their support in the laboratory and Ms. M. Neff-Heinrich for her kind help in editing the paper.
This work has been supported by the Bonfor Research Foundation, University of Bonn, Germany and by NIH RR0163 and DK 62202 and by Scientific Grants from the Austrian Diabetes Association and from Eli Lilly Austria.
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