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Acylation-Stimulating Protein, Leptin, Ghrelin in Bariatric Surgery

About Effects of Roux-en-Y Bypass

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Plasma Acylation-Stimulating Protein, Adiponectin, Leptin, and Ghrelin Before and After Weight Loss Induced by Gastric Bypass Surgery in Morbidly Obese Subjects

Method

We examined fasting plasma insulin, acylation-stimulating protein (ASP), leptin, adiponectin, ghrelin, and metabolic/ cardiovascular risk profile before and 15 +/- 6 months after isolated Roux-en-Y gastric bypass surgery in 50 morbidly obese subjects.

Results

Average preoperative plasma lipids were mostly normal, whereas ASP, insulin, and leptin were elevated, and adiponectin and ghrelin were decreased. Postoperatively, body weight decreased significantly (-36.4 +/- 9.6%) and was best predicted by preoperative adiponectin concentration in weight-stable subjects. Plasma lipids and insulin resistance improved, leptin and ASP decreased, and adiponectin increased. The decrease in apolipoprotein B was best predicted by the decrease in ASP, whereas the improved postoperative insulin sensitivity was best predicted by the increase in adiponectin. Despite bypassing 95% of the stomach and isolating the fundus from contact with ingested nutrients, circulating ghrelin did not decrease after surgery. In fact, plasma ghrelin increased postoperatively in the subset of subjects undergoing active weight loss; ghrelin, however, remained unchanged in weight-stable subjects. In summary, 1) preoperative adiponectin concentrations may be predictive of the extent of weight loss; 2) changes in ASP and adiponectin are predictive of decreased apolipoprotein B and improved insulin action, respectively; and 3) plasma ghrelin increases after gastric bypass surgery in patients experiencing active weight loss

Authors:
Faraj M, Havel PJ, Phelis S, Blank D, Sniderman AD, Cianflone K. Mike Rosenbloom Laboratory for Cardiovascular Research, McGill University, Montreal, Quebec, Canada.

Surgery to Reduce Obesity

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2008 Bariatric-Surgery.Info - Terms - Contact - Information - Resources - Add URL