Full Record & Graph Of A Top 20 Paper in Bariatric Surgery

#2 Paper of the Top 20 Papers in Bariatric Surgery

Title:

Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery

Authors:

Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, Purnell JQ

Source:

NEW ENGLAND JOURNAL OF MEDICINE 346 (21): 1623-1630 MAY 23 2002

Document Type:

Article

Language:

English

Cited References:

Times Cited:

237

Abstract:

Background:
Weight loss causes changes in appetite and energy expenditure that promote weight regain. Ghrelin is a hormone that increases food intake in rodents and humans. If circulating ghrelin participates in the adaptive response to weight loss, its levels should rise with dieting. Because ghrelin is produced primarily by the stomach, weight loss after gastric bypass surgery may be accompanied by impaired ghrelin secretion.
Methods: We determined the 24-hour plasma ghrelin profiles, body composition, insulin levels, leptin levels, and insulin sensitivity in 13 obese subjects before and after a six-month dietary program for weight loss. The 24-hour ghrelin profiles were also determined in 5 subjects who had lost weight after gastric bypass and 10 normal-weight controls; 5 of the 13 obese subjects who participated in the dietary program were matched to the subjects in the gastric-bypass group and served as obese controls.

Results:
Plasma ghrelin levels rose sharply shortly before and fell shortly after every meal. A diet-induced weight loss of 17 percent of initial body weight was associated with a 24 percent increase in the area under the curve for the 24-hour ghrelin profile (P=0.006). In contrast, despite a 36 percent weight loss after gastric bypass, the area under the curve for the ghrelin profile in the gastric-bypass group was 77 percent lower than in normal-weight controls (P<0.001) and 72 percent lower than in matched obese controls (P=0.01). The normal, meal-related fluctuations and diurnal rhythm of the ghrelin level were absent after gastric bypass.

Conclusions:
The increase in the plasma ghrelin level with diet-induced weight loss is consistent with the hypothesis that ghrelin has a role in the long-term regulation of body weight. Gastric bypass is associated with markedly suppressed ghrelin levels, possibly contributing to the weight-reducing effect of the procedure. (N Engl J Med 2002;346:1623-30.) Copyright (C) 2002 Massachusetts Medical Society.

Keywords Plus:

VERTICAL BANDED GASTROPLASTY; QUALITY-OF-LIFE; MORBID-OBESITY; FOOD-INTAKE; ACYLATED PEPTIDE; HORMONE; BEHAVIOR; PERSPECTIVE; RESPONSES; EXERCISE

Addresses:

Cummings DE (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, 1660 S Columbian Way,S-111-Endo, Seattle, WA 98108 USA
Univ Washington, Dept Med, Seattle, WA 98195 USA
Univ Washington, Dept Surg, Seattle, WA 98195 USA
Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA
Univ Hosp, Seattle, WA 98104 USA
Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA

Publisher:

MASSACHUSETTS MEDICAL SOC/NEJM, WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA

Subject Category:

MEDICINE, GENERAL & INTERNAL

IDS Number:

554GZ

ISSN:

0028-4793

Graph - Number of Citations (by year):

Graph not available for this paper.

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