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Erschienen in:
07.11.2019 | Letter to the Editor
No Effect on Change in Fasting Ghrelin at ≤ 12 Months and Increased at ≥ 24 Months After Roux-en-Y Gastric Bypass
Erschienen in: Obesity Surgery | Ausgabe 1/2020
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We read with great interest about ghrelin level changes after undergoing Roux-en-Y gastric bypass (RYGB), which was a controversial outcome. Recently, a meta-analysis by Xu et al. [1] has demonstrated that fasting ghrelin decreased at ≤ 3 months and increased at > 3 months of follow-up after RYGB (standard mean difference (SMD) − 0.49; 95% confidence interval (CI) − 0.98, 0.00; SMD 0.46; 95% CI 0.22, 0.69, respectively). However, this meta-analysis suggested those results in the short term (≤ 3 months, including 32.3 ± 13.1 days, 6 weeks, and 3 months) and long term (> 3 months, range 6 months to 3.6 years). There was no subgroup analysis by detail follow-up time. We searched PubMed, EMBASE, and Web of Science for studies comparing fasting ghrelin pre- and post-RYGB in order to understand this dispute better. Not in line with the study of Xu et al. [1], twenty-six studies [2‐27] were included and the STATA V.12.0 was used to perform the overall and subgroup meta-analysis by different follow-up time (≤ 3 months, 6–12 months, 12 months, and ≥ 24 months). Fasting ghrelin levels at baseline and different follow-up time after RYGB were reported in Table 1. This meta-analysis found that fasting ghrelin increased at ≥ 24 months after RYGB (SMD 0.58; 95% CI 0.01, 1.16) and there was no significant difference demonstrated at ≤ 3 months, 6–12 months, and 12 months (SMD − 0.22; 95% CI − 0.47, 0.02; SMD 0.23; 95% CI − 0.09, 0.55; SMD 0.18; 95% CI − 0.11, 0.48, respectively) (Fig. 1). which was different with Xu et al.’s meta-analysis [1].
Table 1
Fasting ghrelin levels at baseline and different follow-up time after RYGB.
|
Study
|
Ghrelin
|
||||
|---|---|---|---|---|---|
|
Baseline
|
≤ 3 months
|
6–12 months
|
12 months
|
≥ 24 months
|
|
|
Hansen et al.
|
585 ± 272
|
447 ± 89
|
NR
|
NR
|
NR
|
|
Olivan et al.
|
506 ± 121
|
482 ± 196
|
NR
|
NR
|
NR
|
|
Peterli et al.
|
525 ± 66.7
|
457 ± 50
|
NR
|
583.3 ± 50
|
NR
|
|
Chronaiou et al.
|
623 ± 155
|
578 ± 128
|
618 ± 169
|
711 ± 216
|
NR
|
|
Kalinowski et al.
|
74.6 ± 32.4
|
75.6 ± 70.5
|
99.2 ± 85.3
|
130.2 ± 124.3
|
NR
|
|
Karamanakos et al.
|
638 ± 189
|
600 ± 240
|
640 ± 280
|
714 ± 230
|
NR
|
|
Yousseif et al.
|
186 ± 20.2
|
179 ± 16.6
|
NR
|
NR
|
NR
|
|
Ramon et al.
|
584 ± 152.4
|
682.6 ± 146.6
|
NR
|
730 ± 255.7
|
NR
|
|
Jingge Yang et al.
|
401 ± 9
|
400 ± 10
|
396.7 ± 10
|
390 ± 10
|
NR
|
|
Nannipieri et al.
|
32 ± 14
|
28 ± 25
|
NR
|
24 ± 16
|
NR
|
|
Pérez-Romero et al.
|
768.9 ± 203.8
|
NR
|
921.6 ± 344
|
1002.4 ± 354
|
1070 ± 447
|
|
Terra et al.
|
0.97 ± 0.49
|
NR
|
1.17 ± 0.36
|
1.08 ± 0.37
|
NR
|
|
Garcia-Fuentes et al.
|
734.3 ± 286.1
|
NR
|
1137.6 ± 316
|
NR
|
NR
|
|
Mancini et al.
|
742 ± 147
|
NR
|
765 ± 258
|
NR
|
NR
|
|
Alamuddin et al.
|
135.2 ± 15.3
|
NR
|
137 ± 12.4
|
NR
|
NR
|
|
Bose et al.
|
148.2 ± 36.8
|
NR
|
NR
|
211.7 ± 92.1
|
NR
|
|
Bryant et al.
|
678.9 ± 284.9
|
NR
|
NR
|
778.4 ± 376.5
|
NR
|
|
Carrasco et al.
|
846.3 ± 428.4
|
NR
|
NR
|
678.5 ± 290.9
|
NR
|
|
Nosso et al.
|
391 ± 264
|
NR
|
NR
|
443 ± 169
|
NR
|
|
O’Brien et al.
|
538.7 ± 222.3
|
NR
|
NR
|
756.8 ± 513.2
|
NR
|
|
Malin et al.
|
5.83 ± 5.5
|
NR
|
NR
|
5 ± 2.3
|
5.3 ± 2.3
|
|
Svane et al.
|
51 ± 9
|
NR
|
NR
|
42 ± 5
|
NR
|
|
van der Zwaal et al.
|
894 ± 330
|
NR
|
NR
|
NR
|
1069 ± 384
|
|
Borg et al.
|
232 ± 72
|
239 ± 46
|
331 ± 95
|
NR
|
NR
|
|
Tsouristakis et al.
|
336 ± 22
|
NR
|
324 ± 24
|
345 ± 26
|
440 ± 29
|
|
Stoeckli et al.
|
240.4 ± 47.4
|
NR
|
NR
|
NR
|
408 ± 147.8
|
Fig. 1
Meta-analysis by different follow-up time (≤ 3 months, 6–12 months, 12 months, and ≥ 24 months)
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