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Plasma Ghrelin Levels and Weight Regain After Roux-en-Y Gastric Bypass Surgery

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Abstract

Purpose

Ghrelin is a gut hormone that induces hunger, gastric acid secretion, and gastrointestinal motility. A number of studies have previously demonstrated a possible correlation between a decrease in ghrelin level and weight loss after Roux-en-Y gastric bypass (RYGB). This study aimed to assess if there was a relationship between ghrelin level and weight regain after RYGB nadir weight had been achieved.

Materials and Methods

Sixty-three consecutive RYGB patients who were referred for an upper endoscopy were enrolled. Weight and responses to the 21-item Three-Factor Eating Questionnaire (TFEQ-R21) were collected. Ghrelin levels were measured. Upper endoscopy was performed to evaluate pouch length and stoma diameter. Multivariate linear regression was performed to assess an association between ghrelin level, TFEQ-R21 score, pouch length, stoma diameter, and percentage of weight regained.

Results

Subjects were 47 ± 10 years old and had a BMI of 38 ± 7.7 kg/m2. Out of 63 patients, 76 % had weight regain (gaining of ≥20 % of maximal weight lost after the RYGB) and 24 % did not. Average pouch length was 44 ± 13 mm, stoma diameter 20 ± 6.6 mm, and ghrelin levels 125 ± 99 ng/ml. Ghrelin level was not associated with weight regain (β = 0.17, p = 0.2). GJ stoma diameter was associated with weight regain (β = 0.39, p < 0.01) and the uncontrolled eating domain of the TFEQ-R21 (β = 0.45, p < 0.01).

Conclusion

Ghrelin levels do not appear to correlate with weight change after RYGB nadir weight has been achieved. A dilated GJ stoma diameter is a risk factor for weight regain and uncontrolled eating behavior after RYGB.

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Acknowledgment

The project was supported by Harvard Digestive Diseases Center at Harvard Medical School (DK034854).

Authors’ Contributions

Both B. Abu Dayyeh and P. Jirapinyo contributed equally to the project and agreed to be co-first authors.

B. Abu Dayyeh: Data collection and analysis; drafting of the manuscript.

P. Jirapinyo: Data collection and analysis; drafting of the manuscript.

C. Thompson: Study design, critical revision of the manuscript.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Barham K. Abu Dayyeh, Pichamol Jirapinyo & Christopher C. Thompson

  2. Harvard Medical School, Boston, MA, USA

    Barham K. Abu Dayyeh, Pichamol Jirapinyo & Christopher C. Thompson

  3. Mayo Clinic, Rochester, MN, USA

    Barham K. Abu Dayyeh

Authors
  1. Barham K. Abu Dayyeh
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  2. Pichamol Jirapinyo
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  3. Christopher C. Thompson
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Correspondence to Christopher C. Thompson.

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Conflict of Interest

The authors declare that they have no competing interests.

Informed Consent Statement

Informed consent was obtained from all individual participants included in the study.

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Barham K. Abu Dayyeh and Pichamol Jirapinyo are co-first authors.

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Abu Dayyeh, B.K., Jirapinyo, P. & Thompson, C.C. Plasma Ghrelin Levels and Weight Regain After Roux-en-Y Gastric Bypass Surgery. OBES SURG 27, 1031–1036 (2017). https://doi.org/10.1007/s11695-016-2418-3

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  • DOI: https://doi.org/10.1007/s11695-016-2418-3

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