Skip to main content
SpringerLink
Log in

Correlation Between the Number of Ghrelin-Secreting Cells in the Gastric Fundus and Excess Weight Loss after Sleeve Gastrectomy

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Weight loss after laparoscopic sleeve gastrectomy (LSG) has been mainly attributed to the restriction of gastric volume; however; other factors may contribute to weight loss after LSG. This study aimed to investigate the correlation between the number of ghrelin-secreting cells in the gastric fundus and excess weight loss (EWL) at 12 months after LSG.

Methods

The surface area of the gastric fundus was measured postoperatively in square centimeter. Histopathologic examination of the gastric fundus was made to estimate the number of ghrelin-secreting cells per square centimeter then was multiplied by the surface area of the fundus to calculate the total number of ghrelin-secreting cells in the fundus. The number of ghrelin-secreting cells was correlated with EWL and BMI at 12 months postoperatively.

Results

The present study included 39 patients of a mean age of 33.7 years. The mean %EWL at 12 months was 59.7 ± 12.7. The mean total number of ghrelin-producing cells in the gastric fundus was 26,228.4 ± 16,995.3. The total number of ghrelin-secreting cells had a weak positive correlation with BMI at 12 months (r = 0.2891, p = 0.07), and weak negative correlation with %EWL (r = − 0.1592, p = 0.33).

Conclusion

There was a weak correlation between the total number of ghrelin-producing cells in the gastric fundus and plasma ghrelin levels with EWL after LSG.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Vardar E, Öztürk AM, Ersoz D, et al. Routine careful histopathological examination should be performed in sleeve gastrectomy specimens. J Health Sci. 2017;7(1):44–9.

    Article  Google Scholar 

  2. Emile SH, Elfeki H, Elalfy K, et al. Laparoscopic sleeve gastrectomy then and now: an updated systematic review of the progress and short-term outcomes over the last 5 years. Surg Laparosc Endosc Percutan Tech. 2017;00:000–0.

  3. Elbanna HG, Emile SH, El-Hawary GES, et al. Assessment of the correlation between preoperative and immediate postoperative gastric volume and weight loss after sleeve gastrectomy using computed tomography volumetry. World J Surg. 2018; https://doi.org/10.1007/s00268-018-4749-9. [Published ahead of print]

  4. Binda A, Jaworski P, Kudlicka E, et al. The impact of selected factors on parameters of weight loss after sleeve gastrectomy. Videosurgery and other Miniinvasive Techniques. 2016;11(4):288–94. https://doi.org/10.5114/wiitm.2016.64999.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ochner CN, Gibson C, Shanik M, et al. Changes in neurohormonal gut peptides following bariatric surgery. Int J Obes. 2011;35(2):153–66. https://doi.org/10.1038/ijo.2010.132.

    Article  CAS  Google Scholar 

  6. Gündoğan M, Çalli Demırkan N, Tekın K, et al. Gastric histopathological findings and ghrelin expression in morbid obesity. Turk Patoloji Derg. 2013;29(1):19–26. https://doi.org/10.5146/tjpath.2013.01143.

    Article  CAS  PubMed  Google Scholar 

  7. Bohdjalian A et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.

    Article  PubMed  Google Scholar 

  8. Vigneshwaran B, Wahal A, Aggarwal S, et al. Impact of sleeve gastrectomy on type 2 diabetes mellitus, gastric emptying time, glucagon-like peptide 1 (GLP-1), ghrelin and leptin in non-morbidly obese subjects with BMI 30–35.0 kg/ m2 : a prospective study. Obes Surg. 2016;26(12):2817–23.

    Article  CAS  PubMed  Google Scholar 

  9. Bužga M, Zavadilová V, Holéczy P, et al. Dietary intake and ghrelin and leptin changes after sleeve gastrectomy. Videosurgery and other Miniinvasive Techniques. 2014;9(4):554–61. https://doi.org/10.5114/wiitm.2014.45437.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dimitriadis E1, Daskalakis M, Kampa M, et al. Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study. Ann Surg. 2013;257(4):647–54. https://doi.org/10.1097/SLA.0b013e31826e1846.

    Article  PubMed  Google Scholar 

  11. Mahmoud SA, Hussein AF, Omar W, et al. Gastric mucosal changes and ghrelin expression and their relation to weight reduction after sleeve gastrectomy. J Surg. 2018;6(2):36–42.

    Article  Google Scholar 

  12. Ogden CL et al. Trends in obesity among adults in the United States, 2. JAMA. 2016;315:2284–91. https://doi.org/10.1001/jama.2016.6458.

    Article  CAS  PubMed  Google Scholar 

  13. Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(1):177–83.

    Article  PubMed  Google Scholar 

  14. Elbanna H, Ghnnam W, Negm A, et al. Impact of preoperative body mass index on the final outcome after laparoscopic sleeve gastrectomy for morbid obesity. Ulus Cerrahi Derg. 2016;32(4):238–43. https://doi.org/10.5152/UCD.2016.3275. eCollection 2016.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Braghetto I, Burgos AM, Gutiérrez L, et al. Length and Volume of the resected stomach in patients with morbid obesity submitted to Sleeve Gastrectomy or resective Gastric Bypass compared to Controls. BMI - Bariátrica E Metabólica Iberoam. 2011;1:9–13.

    Google Scholar 

  16. Alamuddin N et al. Changes in fasting and prandial gut and adiposity hormones following vertical sleeve gastrectomy or Roux-en-Y-gastric bypass: an 18-month prospective study. Obes Surg. 2017;27(6):1563–72.

    Article  PubMed  Google Scholar 

  17. Goitein D, Lederfein D, Tzioni R, et al. Mapping of ghrelin gene expression and cell distribution in the stomach of morbidly obese patients possible guide for efficient sleeve gastrectomy construction. Obes Surg. 2012;22(4):617–22. https://doi.org/10.1007/s11695-011-0585-9.

    Article  PubMed  Google Scholar 

  18. Maksud FAN, Alves JS, Diniz MTC, et al. Density of ghrelin-producing cells is higher in the gastric mucosa of morbidly obese patients. Eur J Endocrinol. 2011;165:57–62.

    Article  CAS  PubMed  Google Scholar 

  19. Nass R, Pezzoli SS, Oliveri MC, et al. Effects of an oral ghrelin mimetic on body composition and clinical outcomes in healthy older adults: a randomized trial. Ann Intern Med. 2008;149(9):601–11.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Asakawa A, Inui A, Kaga T, et al. A role of ghrelin in neuroendocrine and behavioral responses to stress in mice. Neuroendocrinology. 2001;74(3):143–7.

    Article  CAS  PubMed  Google Scholar 

  21. Ariyasu H, Takaya K, Tagami T, et al. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab. 2001;86(10):4753–8.

    Article  CAS  PubMed  Google Scholar 

  22. Rosas et al. The influence of resected gastric weight upon weight loss after sleeve gastrectomy. Am Surg. 2015;81(12):1240–3.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Faculty of medicine, Mansoura University, Mansoura City, Egypt

    Abdulaziz Itlaybah, Hosam Elbanna, Sameh Emile, Waleed Thabet, Ahmed AbdelMawla & Haitham Elkaffas

  2. Pathology Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Wagdi Elkashef

  3. Rheumatology and Immunology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University Hospitals, Mansoura University, Mansoura City, Egypt

    Noha Abdelsalam

Authors
  1. Abdulaziz Itlaybah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hosam Elbanna
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sameh Emile
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Waleed Thabet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wagdi Elkashef
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Noha Abdelsalam
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ahmed AbdelMawla
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Haitham Elkaffas
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Hossam Elbanna and Abdulaziz Itlaybah designed the study and contributed to data collection and analysis and writing of the manuscript. Sameh Emile, Ahmed AbdelMawla, and Waleed Thabet contributed in data collection and analysis and writing of the manuscript. Wagdi Elkashef performed histopathologic examination of the gastric fundus for ghrelin-secreting cells and contributed to data collection and analysis. Haitham Elkaffas contributed to data analysis, drafting, and revision of the manuscript. Noha Abdelsalam contributed to follow-up of patients, providing nutritional support after surgery, data collection, and drafting of the manuscript.

Corresponding author

Correspondence to Sameh Emile.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

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

Statement of Human and Animal Rights

This study was conducted in accordance with the declaration of Helsinki. Ethical approval for the study was obtained from the Institutional Review Board (IRB) of Mansoura Faculty of Medicine.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Itlaybah, A., Elbanna, H., Emile, S. et al. Correlation Between the Number of Ghrelin-Secreting Cells in the Gastric Fundus and Excess Weight Loss after Sleeve Gastrectomy. OBES SURG 29, 76–83 (2019). https://doi.org/10.1007/s11695-018-3498-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-018-3498-z

Keywords

Search

Navigation