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Erschienen in: Obesity Surgery 11/2013

01.11.2013 | Original Contributions

Long-term Changes in Leptin, Chemerin and Ghrelin Levels Following Different Bariatric Surgery Procedures: Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

verfasst von: Ximena Terra, Teresa Auguet, Esther Guiu-Jurado, Alba Berlanga, Josep Maria Orellana-Gavaldà, Mercè Hernández, Fàtima Sabench, Jose Antonio Porras, Jordi Llutart, Salomé Martinez, Carmen Aguilar, Daniel Del Castillo, Cristóbal Richart

Erschienen in: Obesity Surgery | Ausgabe 11/2013

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Abstract

Background

Different studies have evaluated changes in adipo/cytokine levels after bariatric surgery and have given conflicting results. The adipo/cytokines, leptin and chemerin, and the orexigenic hormone, ghrelin, have been shown to play a role in the regulation of metabolism and appetite. The aims of our study were to test the levels of these molecules after bariatric surgery and to compare the results between Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy.

Methods

We analysed circulating levels of chemerin, ghrelin and leptin in 30 morbidly obese women (body mass index of >40 kg/m2). Subjects were studied at three time points: baseline (before the surgery started), and after 6 and 12 months.

Results

After surgery, chemerin (baseline, 95.03 ± 23.79; after 12 months, 76.80 ± 21.51; p = 0.034) and leptin levels (baseline, 248.17 ± 89.16; after 12 months, 63.85 ± 33.48; p < 0.001) were significantly lower than their baseline levels, whereas ghrelin was higher (baseline, 0.87 ± 0.38; after 12 months, 1.08 ± 0.31; p = 0.010). Fasting glucose, insulin and homeostasis model assessment of insulin resistance levels were markedly lower postoperatively. High-density lipoprotein levels moderately increased and triglyceride levels sharply decreased. There were no differences between the types of bariatric surgery in terms of weight reduction, general metabolic state or adipo/cytokine levels after surgery.

Conclusions

Our study demonstrates a marked decrease in fasting leptin and chemerin levels, and an increase in ghrelin levels, after bariatric surgery-induced weight loss, independently of the type of surgery performed. Further studies are needed on the interrelation between the changes in the circulating levels of these molecules and the efficacy of the bariatric surgery procedures to induce the beneficial metabolic changes and to sustain body weight loss.
Literatur
1.
Zurück zum Zitat Gass M, Beglinger C, Peterli R. Metabolic surgery—principles and current concepts. Langenbecks Arch Surg. 2011;396(7):949–72.PubMedCrossRef Gass M, Beglinger C, Peterli R. Metabolic surgery—principles and current concepts. Langenbecks Arch Surg. 2011;396(7):949–72.PubMedCrossRef
2.
Zurück zum Zitat Magee C, Barry J, Arumugasamy M, et al. Laparoscopic sleeve gastrectomy for high-risk patients: weight loss and comorbidity improvement—short-term results. Obes Surg. 2011;21(5):547–50.PubMedCrossRef Magee C, Barry J, Arumugasamy M, et al. Laparoscopic sleeve gastrectomy for high-risk patients: weight loss and comorbidity improvement—short-term results. Obes Surg. 2011;21(5):547–50.PubMedCrossRef
3.
Zurück zum Zitat Czupryniak L, Pawlowski M, Kumor A, et al. Predicting maximum Roux-en-Y gastric bypass-induced weight reduction—preoperative plasma leptin or body weight? Obes Surg. 2007;17(2):162–7.PubMedCrossRef Czupryniak L, Pawlowski M, Kumor A, et al. Predicting maximum Roux-en-Y gastric bypass-induced weight reduction—preoperative plasma leptin or body weight? Obes Surg. 2007;17(2):162–7.PubMedCrossRef
4.
Zurück zum Zitat Hajer GR, van Haeften TW, Visseren FLJ. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29(24):2959–71.PubMedCrossRef Hajer GR, van Haeften TW, Visseren FLJ. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008;29(24):2959–71.PubMedCrossRef
5.
Zurück zum Zitat Beckman LM, Beckman TR, Sibley SD, et al. Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass surgery. JPEN J Parenter Enteral Nutr. 2011;35(2):169–80.PubMedCrossRef Beckman LM, Beckman TR, Sibley SD, et al. Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass surgery. JPEN J Parenter Enteral Nutr. 2011;35(2):169–80.PubMedCrossRef
6.
Zurück zum Zitat Friedman JM. Obesity in the new millennium. Nature. 2000;404(6778):632–4.PubMed Friedman JM. Obesity in the new millennium. Nature. 2000;404(6778):632–4.PubMed
7.
Zurück zum Zitat Ress C, Tschoner A, Engl J, et al. Effect of bariatric surgery on circulating chemerin levels. Eur J Clin Invest. 2010;40(3):277–80.PubMedCrossRef Ress C, Tschoner A, Engl J, et al. Effect of bariatric surgery on circulating chemerin levels. Eur J Clin Invest. 2010;40(3):277–80.PubMedCrossRef
8.
Zurück zum Zitat Chakaroun R, Raschpichler M, Klöting N, et al. Effects of weight loss and exercise on chemerin serum concentrations and adipose tissue expression in human obesity. Metab Clin Exp. 2012;61(5):706–14.PubMedCrossRef Chakaroun R, Raschpichler M, Klöting N, et al. Effects of weight loss and exercise on chemerin serum concentrations and adipose tissue expression in human obesity. Metab Clin Exp. 2012;61(5):706–14.PubMedCrossRef
9.
Zurück zum Zitat Ernst MC, Sinal CJ. Chemerin: at the crossroads of inflammation and obesity. Trends Endocrinol Metab. 2010;21(11):660–7.PubMedCrossRef Ernst MC, Sinal CJ. Chemerin: at the crossroads of inflammation and obesity. Trends Endocrinol Metab. 2010;21(11):660–7.PubMedCrossRef
10.
Zurück zum Zitat Bozaoglu K, Bolton K, McMillan J, et al. Chemerin is a novel adipokine associated with obesity and metabolic syndrome. Endocrinology. 2007;148(10):4687–94.PubMedCrossRef Bozaoglu K, Bolton K, McMillan J, et al. Chemerin is a novel adipokine associated with obesity and metabolic syndrome. Endocrinology. 2007;148(10):4687–94.PubMedCrossRef
11.
Zurück zum Zitat Bozaoglu K, Segal D, Shields KA, et al. Chemerin is associated with metabolic syndrome phenotypes in a Mexican-American population. J Clin Endocrinol Metab. 2009;94(8):3085–8.PubMedCrossRef Bozaoglu K, Segal D, Shields KA, et al. Chemerin is associated with metabolic syndrome phenotypes in a Mexican-American population. J Clin Endocrinol Metab. 2009;94(8):3085–8.PubMedCrossRef
12.
Zurück zum Zitat Kirchner H, Heppner KM, Tschöp MH. The role of ghrelin in the control of energy balance. Handb Exp Pharmacol. 2012;209:161–84.PubMedCrossRef Kirchner H, Heppner KM, Tschöp MH. The role of ghrelin in the control of energy balance. Handb Exp Pharmacol. 2012;209:161–84.PubMedCrossRef
13.
Zurück zum Zitat Ortega E, Morínigo R, Flores L, et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc. 2012;26(6):1744–50.PubMedCrossRef Ortega E, Morínigo R, Flores L, et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc. 2012;26(6):1744–50.PubMedCrossRef
14.
Zurück zum Zitat Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.PubMedCrossRef Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.PubMedCrossRef
15.
Zurück zum Zitat Stefater MA, Wilson-Pérez HE, Chambers AP, et al. All bariatric surgeries are not created equal: Insights from mechanistic comparisons. Endocr Rev. 2012. doi:10.1210/er.2011-1044.PubMed Stefater MA, Wilson-Pérez HE, Chambers AP, et al. All bariatric surgeries are not created equal: Insights from mechanistic comparisons. Endocr Rev. 2012. doi:10.​1210/​er.​2011-1044.PubMed
16.
Zurück zum Zitat Chu SH, Lee MK, Ahn KY, et al. Chemerin and adiponectin contribute reciprocally to metabolic syndrome. PLoS One. 2012;7(4):e34710.PubMedCrossRef Chu SH, Lee MK, Ahn KY, et al. Chemerin and adiponectin contribute reciprocally to metabolic syndrome. PLoS One. 2012;7(4):e34710.PubMedCrossRef
17.
Zurück zum Zitat Shin H, Lee DC, Chu SH, et al. Chemerin levels are positively correlated with abdominal visceral fat accumulation. Clin Endocrinol. 2011;77(1):47–50.CrossRef Shin H, Lee DC, Chu SH, et al. Chemerin levels are positively correlated with abdominal visceral fat accumulation. Clin Endocrinol. 2011;77(1):47–50.CrossRef
18.
Zurück zum Zitat Sell H, Divoux A, Poitou C, et al. Chemerin correlates with markers for fatty liver in morbidly obese patients and strongly decreases after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2010;95(6):2892–6.PubMedCrossRef Sell H, Divoux A, Poitou C, et al. Chemerin correlates with markers for fatty liver in morbidly obese patients and strongly decreases after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2010;95(6):2892–6.PubMedCrossRef
19.
Zurück zum Zitat Shiiya T, Nakazato M, Mizuta M, et al. Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J Clin Endocrinol Metab. 2002;87(1):240–4.PubMedCrossRef Shiiya T, Nakazato M, Mizuta M, et al. Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J Clin Endocrinol Metab. 2002;87(1):240–4.PubMedCrossRef
20.
Zurück zum Zitat Gletsu LE. The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. Arch Surg. 2004;139(7):780–4.PubMedCrossRef Gletsu LE. The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. Arch Surg. 2004;139(7):780–4.PubMedCrossRef
21.
Zurück zum Zitat Peterli R, Steinert R, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8.PubMedCrossRef Peterli R, Steinert R, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8.PubMedCrossRef
22.
Zurück zum Zitat Fruhbeck G, Rotellar F, Hernandez-Lizoain JL, et al. Fasting plasma ghrelin concentrations 6 months after gastric bypass are not determined by weight loss or changes in insulinemia. Obes Surg. 2004;14(9):1208–15.PubMedCrossRef Fruhbeck G, Rotellar F, Hernandez-Lizoain JL, et al. Fasting plasma ghrelin concentrations 6 months after gastric bypass are not determined by weight loss or changes in insulinemia. Obes Surg. 2004;14(9):1208–15.PubMedCrossRef
23.
Zurück zum Zitat Faraj M, Havel PJ, Phelis S, et al. Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab. 2003;88(4):1594–602.PubMedCrossRef Faraj M, Havel PJ, Phelis S, et al. Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab. 2003;88(4):1594–602.PubMedCrossRef
24.
Zurück zum Zitat Stratis C, Alexandrides T, Vagenas K, et al. Ghrelin and peptide YY levels after a variant of biliopancreatic diversion with Roux-en-Y gastric bypass versus after colectomy: a prospective comparative study. Obes Surg. 2006;16(6):752–8.PubMedCrossRef Stratis C, Alexandrides T, Vagenas K, et al. Ghrelin and peptide YY levels after a variant of biliopancreatic diversion with Roux-en-Y gastric bypass versus after colectomy: a prospective comparative study. Obes Surg. 2006;16(6):752–8.PubMedCrossRef
26.
Zurück zum Zitat Oliván B, Teixeira J, Bose M, et al. Effect of weight loss by diet or gastric bypass surgery on peptide YY3-36 levels. World J Surg. 2011;35:2022–30.CrossRef Oliván B, Teixeira J, Bose M, et al. Effect of weight loss by diet or gastric bypass surgery on peptide YY3-36 levels. World J Surg. 2011;35:2022–30.CrossRef
27.
Zurück zum Zitat Brethauer S, Heneghan H, Eldar S, et al. Early effects of gastric bypass on endothelial function, inflammation, and cardiovascular risk in obese patients. Surg Endosc. 2011;25:2650–9.PubMedCrossRef Brethauer S, Heneghan H, Eldar S, et al. Early effects of gastric bypass on endothelial function, inflammation, and cardiovascular risk in obese patients. Surg Endosc. 2011;25:2650–9.PubMedCrossRef
28.
Zurück zum Zitat Felberbauer F, Langer F, Shakeri-Manesch S, et al. Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obes Surg. 2008;18(7):814–8.PubMedCrossRef Felberbauer F, Langer F, Shakeri-Manesch S, et al. Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obes Surg. 2008;18(7):814–8.PubMedCrossRef
29.
Zurück zum Zitat Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–8.PubMedCrossRef Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–8.PubMedCrossRef
30.
Zurück zum Zitat Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21(9):1458–68.PubMedCrossRef Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21(9):1458–68.PubMedCrossRef
31.
Zurück zum Zitat Woodard GA, Peraza J, Bravo S, et al. One year improvements in cardiovascular risk factors: a comparative trial of laparoscopic Roux-en-Y gastric bypass vs. adjustable gastric banding. Obes Surg. 2010;20(5):578–82.PubMedCrossRef Woodard GA, Peraza J, Bravo S, et al. One year improvements in cardiovascular risk factors: a comparative trial of laparoscopic Roux-en-Y gastric bypass vs. adjustable gastric banding. Obes Surg. 2010;20(5):578–82.PubMedCrossRef
32.
Zurück zum Zitat Benaiges D, Goday A, Ramon JM, et al. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis. 2011;7(5):575–80.PubMedCrossRef Benaiges D, Goday A, Ramon JM, et al. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis. 2011;7(5):575–80.PubMedCrossRef
33.
Zurück zum Zitat Korner J, Inabnet W, Conwell IM, et al. Differential effects of gastric bypass and banding on circulating gut hormone and leptin levels. Obesity (Silver Spring). 2006;14(9):1553–61.CrossRef Korner J, Inabnet W, Conwell IM, et al. Differential effects of gastric bypass and banding on circulating gut hormone and leptin levels. Obesity (Silver Spring). 2006;14(9):1553–61.CrossRef
34.
Zurück zum Zitat Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin. Nature. 1998;394(6695):790–3.PubMedCrossRef Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin. Nature. 1998;394(6695):790–3.PubMedCrossRef
Metadaten
Titel
Long-term Changes in Leptin, Chemerin and Ghrelin Levels Following Different Bariatric Surgery Procedures: Roux-en-Y Gastric Bypass and Sleeve Gastrectomy
verfasst von
Ximena Terra
Teresa Auguet
Esther Guiu-Jurado
Alba Berlanga
Josep Maria Orellana-Gavaldà
Mercè Hernández
Fàtima Sabench
Jose Antonio Porras
Jordi Llutart
Salomé Martinez
Carmen Aguilar
Daniel Del Castillo
Cristóbal Richart
Publikationsdatum
01.11.2013
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 11/2013
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-1033-9

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