The effects of gastric surgery on systemic ghrelin levels in the morbidly obese

Edward Lin, Nana Gletsu, Kim Fugate, David McClusky, Li H. Gu, Juan Li Zhu, Bruce Ramshaw, Dimitris A. Papanicolaou, Thomas R. Ziegler, C. Daniel Smith

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Hyphothesis: Circulating ghrelin, produced primarily in the stomach, is a powerful orexigen. Ghrelin levels are elevated in states of hunger, but rapidly decline post-prandially. Early alterations in ghrelin levels in morbidly obese patients undergoing weight reduction surgery may be attributed to gastric partitioning. Design and Patients: Thirty-four patients underwent Roux-en-Y gastric bypass with a completely divided gastroplasty to create a 15-mL vertically oriented gastric pouch. Eight other patients underwent other gastric procedures that did not involve complete division of the stomach, including 4 vertical banded gastroplasties and 4 antireflux surgical procedures. Six additional patients undergoing antireflux surgery served as lean control subjects. Plasma samples were obtained before surgery and immediately after surgery. In a substudy, plasma was collected after Roux-en-Y limb formation and after dividing the stomach to identify any changes in plasma ghrelin levels. Setting: Tertiary university medical center. Main Outcome Measures: Ghrelin levels at different stages of surgical intervention. Results: Mean±SEM preoperative and postoperative ghrelin levels in the gastric bypass group were 355±20 and 246±13 pg/mL, respectively (P<.001). In the vertical banded gastroplasty group and in all patients undergoing antireflux surgery, ghrelin levels were not significantly changed. Conclusion: Compared with morbidly obese humans, lean controls had significantly higher plasma ghrelin levels at baseline. A divided gastroplasty creating a small proximal gastric pouch results in significant early declines in circulating ghrelin levels that are not observed with other gastric procedures. This may explain, in part, the loss of hunger sensation and rapid weight loss observed following gastric bypass surgery.

Original languageEnglish (US)
Pages (from-to)780-784
Number of pages5
JournalArchives of Surgery
Volume139
Issue number7
DOIs
StatePublished - Jul 1 2004

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Ghrelin
Stomach
Gastroplasty
Gastric Bypass
Hunger
Weight Loss
Extremities
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Lin, E., Gletsu, N., Fugate, K., McClusky, D., Gu, L. H., Zhu, J. L., ... Smith, C. D. (2004). The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. Archives of Surgery, 139(7), 780-784. https://doi.org/10.1001/archsurg.139.7.780

The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. / Lin, Edward; Gletsu, Nana; Fugate, Kim; McClusky, David; Gu, Li H.; Zhu, Juan Li; Ramshaw, Bruce; Papanicolaou, Dimitris A.; Ziegler, Thomas R.; Smith, C. Daniel.

In: Archives of Surgery, Vol. 139, No. 7, 01.07.2004, p. 780-784.

Research output: Contribution to journalArticle

Lin, E, Gletsu, N, Fugate, K, McClusky, D, Gu, LH, Zhu, JL, Ramshaw, B, Papanicolaou, DA, Ziegler, TR & Smith, CD 2004, 'The effects of gastric surgery on systemic ghrelin levels in the morbidly obese', Archives of Surgery, vol. 139, no. 7, pp. 780-784. https://doi.org/10.1001/archsurg.139.7.780
Lin, Edward ; Gletsu, Nana ; Fugate, Kim ; McClusky, David ; Gu, Li H. ; Zhu, Juan Li ; Ramshaw, Bruce ; Papanicolaou, Dimitris A. ; Ziegler, Thomas R. ; Smith, C. Daniel. / The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. In: Archives of Surgery. 2004 ; Vol. 139, No. 7. pp. 780-784.
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