Gut and Metabolic Hormones Changes After Endoscopic Sleeve Gastroplasty (ESG) Vs. Laparoscopic Sleeve Gastrectomy (LSG)
- PDF / 2,720,359 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 33 Downloads / 258 Views
ORIGINAL CONTRIBUTIONS
Gut and Metabolic Hormones Changes After Endoscopic Sleeve Gastroplasty (ESG) Vs. Laparoscopic Sleeve Gastrectomy (LSG) Gontrand Lopez-Nava 1 & Anuradha Negi 1 & Inmaculada Bautista-Castaño 1 & Miguel Angel Rubio 2 & Ravishankar Asokkumar 1,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction ESG reduces gastric lumen similar to LSG and induces significant weight loss. However, the metabolic and physiological alteration after ESG is not fully understood. We aim to study the gastrointestinal hormone changes after ESG and compared it with LSG. Methods We conducted a prospective pilot study comparing ESG and LSG at two centers in Spain. We administered a standard test meal after an overnight fast, and collected blood samples before and after meal. We measured the levels of ghrelin, GLP-1, peptide-YY, insulin, leptin, and adiponectin. We evaluated the hormone profile and weight changes (%TBWL) at baseline and at 6 months after the procedure. Results Twenty-four patients were recruited (ESG-12, LSG-12). The baseline age, sex, BMI, and fasting hormone levels were similar between the groups. At 6-month post-ESG, there was a significant decline in the leptin levels. We found a trend towards a decrease in insulin levels and improvement in insulin secretory pattern. We did not observe any change in fasting ghrelin levels, GLP-1, and PYY. At 6 months, LSG induced a significant reduction in the ghrelin, and leptin levels, and increase in peptide-YY, and adiponectin levels, respectively. A trend towards an increase in GLP-1 level was noted. However, no change in insulin was observed. LSG achieved greater %TBWL (24.4 vs. 13.3, p < 0.001) and significantly change in ghrelin, PYY, and adiponectin levels at 6 months compared to ESG. Conclusion ESG induced gut hormone changes differently as compared to LSG. ESG prevented a compensatory rise in ghrelin and promoted beneficial changes in the insulin secretory pattern with weight loss. Keywords ESG . LSG . Hormone changes . Weight loss
Abbreviations ESG Endoscopic sleeve gastroplasty LSG Laparoscopic sleeve gastrectomy GLP-1 Glucagon like peptide PYY Peptide-YY Gontrand Lopez-Nava and Anuradha Negi contributed equally to this work. * Ravishankar Asokkumar [email protected] 1
Bariatric Endoscopy Unit, HM Sanchinarro University Hospital, Calle de Oña, 28050 Madrid, Spain
2
Department of Nutrition and Clinical Diabetes, Hospital Clinico San Carlos, Madrid, Spain
3
Department of Gastroenterology and Hepatology, Singapore General Hospital, Bukit Merah, Singapore
BMI AUC SD HOMA-IR MMT RIA
Body mass index Area under concentration time curve Standard deviation Homeostatic model assessment of insulin resistance Mixed meal test Radioimmunoassay
Introduction Obesity is a state of imbalance between calorie excess and energy expenditure. The chronic positive energy balance overrides some of the homeostatic signals resulting in excess adiposity and weight gain [1, 2]. Gut hormones secreted by the enteroendocrine cells ar
Data Loading...
