Skip to main content
SpringerLink
Log in

Persistent Correlation of Ghrelin Plasma Levels with Body Mass Index Both in Stable Weight Conditions and during Gastric-bypass-induced Weight Loss

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Studies done on serial changes in plasma ghrelin levels after gastric bypass (GBP) have yielded contrasting results since decreased, unchanged, or increased levels have been reported in the literature. This study investigates whether or not GBP has an inhibitory effect on fasting ghrelin levels independently of weight loss.

Methods

Fasting ghrelin levels were measured in 115 stable body weight females, classified as normal body weight (NW; body mass index (BMI) < 25 kg/m2), overweight (OW; BMI 25–30 kg/m2), and obese subjects, divided in three subgroups with increasing BMI (BMI 30–40 kg/m2; BMI 40–50 kg/m2; BMI >50 kg/m2).

Results

Each obese subgroup showed significantly lower ghrelin levels as compared to both NW (p < 0.0001) and OW subjects (p < 0.05 or 0.005); however, no significant differences were observed within the three obese subgroups. Forty-nine obese patients underwent a GBP. Plasma ghrelin, measured at 3, 6, and 12 months after GBP, significantly increased from the sixth month on (p < 0.0001). When patients were classified, at each postoperative time point, according to their actual BMI, ghrelin was significantly (p = 0.0002) related to postoperative BMI and not significantly different from ghrelin measured in stable body weight conditions.

Conclusions

Fasting ghrelin displays an inversely significant correlation with BMI in both stable body weight conditions and after GBP. No evidence was found that GBP had an effect on fasting ghrelin levels, independent of weight loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Seidell JC. Obesity, insulin resistance and diabetes—a worldwide epidemic. Br J Nutr 2000;83(Suppl 1):S5–8.

    CAS  PubMed  Google Scholar 

  2. DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med 2007;356:2176–83.

    Article  CAS  Google Scholar 

  3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292:1724–37.

    Article  CAS  Google Scholar 

  4. Gumbs AA, Modlin IM, Ballantyne GH. Changes in insulin resistance following bariatric surgery: role of caloric restriction and weight loss. Obes Surg 2005;15:462–73.

    Article  Google Scholar 

  5. le Roux CW, Aylwin SJ, Batterham RL, et al. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg 2006;243:108–14.

    Article  Google Scholar 

  6. Horvath TL, Diano S, Sotonyi P, et al. Minireview: ghrelin and the regulation of energy balance—a hypothalamic perspective. Endocrinology 2001;142:4163–9.

    Article  CAS  Google Scholar 

  7. Bray GA. Afferent signals regulating food intake. Proc Nutr Soc 2000;59:373–84.

    Article  CAS  Google Scholar 

  8. Jeanrenaud B, Rohner-Jeanrenaud F. CNS–periphery relationships and body weight homeostasis: influence of the glucocorticoid status. Int J Obes Relat Metab Disord 2000;24(Suppl 2):S74–6.

    Article  CAS  Google Scholar 

  9. Schwartz MW, Woods SC, Porte D Jr, et al. Central nervous system control of food intake. Nature 2000;404:661–71.

    Article  CAS  Google Scholar 

  10. Cummings DE, Shannon MH. Roles for ghrelin in the regulation of appetite and body weight. Arch Surg 2003;138:389–96.

    Article  CAS  Google Scholar 

  11. Nijhuis J, van Dielen FM, Buurman WA, et al. Ghrelin, leptin and insulin levels after restrictive surgery: a 2-year follow-up study. Obes Surg 2004;14:783–7.

    Article  Google Scholar 

  12. Stoeckli R, Chanda R, Langer I, et al. Changes of body weight and plasma ghrelin levels after gastric banding and gastric bypass. Obes Res 2004;12:346–50.

    Article  CAS  Google Scholar 

  13. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005;15:1024–9.

    Article  CAS  Google Scholar 

  14. Geloneze B, Tambascia MA, Pilla VF, et al. Ghrelin: a gut-brain hormone effect: of gastric bypass surgery. Obes Surg 2003;13:17–22.

    Article  Google Scholar 

  15. Faraj M, Havel PJ, Phélis 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;88:1594–602.

    Article  CAS  Google Scholar 

  16. Holdstock C, Engström B, Ohrvall M, et al. Ghrelin and adipose tissue regulatory peptides: effect of gastric bypass surgery in obese humans. J Clin Endocrinol Metab 2003;88:3177–83.

    Article  CAS  Google Scholar 

  17. Stylopoulos N, Davis P, Pettit JD, et al. Changes in serum ghrelin predict weight loss after Roux-en-Y gastric bypass in rats. Surg Endosc 2005;19:942–6.

    Article  CAS  Google Scholar 

  18. Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg 2003;13:159–60.

    Article  Google Scholar 

  19. Deitel M, Gawdat K, Melissas J. Reporting weight loss. Obes Surg 2007;17:565–8.

    Article  Google Scholar 

  20. Cummings DE, Frayo RS, Purnell JQ, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002;346:1623–30.

    Article  Google Scholar 

  21. Tschop M, Weyer C, Tataranni PA, et al. Circulating ghrelin levels are decreased in human obesity. Diabetes 2001;50:707–9.

    Article  CAS  Google Scholar 

  22. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;42:97–118.

    Google Scholar 

  23. Sugerman HJ, Kral JG. Evidence-based medicine reports on obesity surgery: a critique. Int J Obes Relat Metab Disord 2005;29:735–74.

    Article  CAS  Google Scholar 

  24. Trostler N, Mann A, Zilberbush N, et al. Weight loss and food intake 18 months following vertical banded gastroplasty or gastric bypass for severe obesity. Obes Surg 1995;5:39–51.

    Article  CAS  Google Scholar 

  25. Brolin RE. Bariatric surgery and long-term control of morbid obesity. JAMA 2002;288:2793–6.

    Article  Google Scholar 

  26. Fruhbeck G, Diez Caballero A, Gil MJ. Fundus functionality and ghrelin concentrations after bariatric surgery. N Engl J Med 2004;15:308–9.

    Article  Google Scholar 

  27. Fruhbeck G, Gil MJ, Cienfuegos JA, et al. The decrease in plasma ghrelin concentrations following bariatric surgery depends on the functional integrity of the fundus. Obes Surg 2004;14:606–12.

    Article  Google Scholar 

  28. Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg 2002;12:540–5.

    Article  Google Scholar 

  29. Cummings DE, Shannon MH. Ghrelin and gastric bypass: is there a hormonal contribution to surgical weight loss? J Clin Endocrinol Metab 2003;88:2999–3002.

    Article  CAS  Google Scholar 

  30. Leonetti F, Iacobellis G, Di Mario U, et al. Different plasma ghrelin levels after laparoscopic gastric bypass and adjustable gastric banding in morbid obese subjects. J Clin Endocrinol Metab 2003;88:4227–31.

    Article  CAS  Google Scholar 

  31. Korner J, Cirilo LJ, Wardlaw SL, et al. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin. J Clin Endocrinol Metab 2005;90:359–65.

    Article  CAS  Google Scholar 

  32. Tritos NA, Mun E, Bertkau A, et al. Serum ghrelin levels in response to glucose load in obese subjects post-gastric bypass surgery. Obes Res 2003;11:919–24.

    Article  CAS  Google Scholar 

  33. Lin E, Fugate K, Smith CD, et al. The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. Arch Surg 2004;139:780–4.

    Article  Google Scholar 

  34. Morínigo R, Moizé V, Vidal J, et al. Short-term effects of gastric bypass surgery on circulating ghrelin levels. Obes Res 2004;12:1108–16.

    Article  Google Scholar 

  35. Fruhbeck G, Hernandez-Lizoain JL, Cienfuegos JA, et al. Fasting plasma ghrelin concentrations 6 months after gastric bypass are not determined by weight loss or changes in insulinemia. Obes Surg 2004;14:1208–15.

    Article  Google Scholar 

  36. Christou NV, Look D, McLean AP. Pre- and post-prandial plasma ghrelin levels do not correlate with satiety or failure to achieve a successful outcome after Roux-en-Y gastric bypass. Obes Surg 2005;15:1017–23.

    Article  Google Scholar 

  37. Pope GD, Birkmeyer JD, Finlayson SR. National trends in utilization and in-hospital outcomes of bariatric surgery. J Gastrointest Surg 2002;6:855–60.

    Article  Google Scholar 

  38. Vendrell J, Broch M, Richart C, et al. Resistin, adiponectin, ghrelin, leptin, and proinflammatory cytokines: relationships in obesity. Obes Res 2004;12:962–71.

    Article  CAS  Google Scholar 

  39. Kojima M, Hosoda H, Date Y, et al. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 1999;402:656–60.

    Article  CAS  Google Scholar 

Download references

Conflicts of interest

None to disclose.

Author information

Authors and Affiliations

  1. Instituto de Cardiología Avanzada, Centro Medico Teknon, Barcelona, Spain

    J. Ybarra

  2. Service of Therapeutic Education for Chronic Diseases, Geneva University Hospital, 1211, Geneva, Switzerland

    E. Bobbioni-Harsch & A. Golay

  3. Clinic of Digestive Surgery, Geneva University Hospital, Geneva, Switzerland

    G. Chassot, O. Huber & Ph. Morel

  4. Department of Cell Physiology and Metabolism, Geneva Medical School, 1211, Geneva, Switzerland

    F. Assimacopoulos-Jeannet

Authors
  1. J. Ybarra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Bobbioni-Harsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Chassot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. O. Huber
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ph. Morel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Assimacopoulos-Jeannet
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Golay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Bobbioni-Harsch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ybarra, J., Bobbioni-Harsch, E., Chassot, G. et al. Persistent Correlation of Ghrelin Plasma Levels with Body Mass Index Both in Stable Weight Conditions and during Gastric-bypass-induced Weight Loss. OBES SURG 19, 327–331 (2009). https://doi.org/10.1007/s11695-008-9748-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-008-9748-8

Keywords

Search

Navigation