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Effects of Two Variants of Roux-en-Y Gastric Bypass on Metabolism Behaviour: Focus on Plasma Ghrelin Concentrations Over a 2-Year Follow-up

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Abstract

Background

To study the effects of two variants of Roux-en-Y gastric bypass (RYGBP) on plasma ghrelin concentrations according to different exposure of gastric fundus to the nutrient pathway.

Methods

A prospective longitudinal 2-year follow-up study was conducted. Ninety-six morbidly obese (MO) patients (age range: 41.6 ± 9.6 years, body mass index: 53 ± 9.5 kg/m2) were assigned to two bariatric surgical (BS) procedures: one that preserves food contact with gastric fundus (ringed RYGBP, n = 50) and the other that avoids it (modified RYGBP, n = 46). Different anthropometric and biochemical parameters were studied, focusing on ghrelin concentrations at baseline and 6, 12, and 24 months post-BS.

Results

At 24 months post-BS, all metabolic parameters studied had improved in all patients compared with those at 1-year follow-up and baseline (p < 0.05). However, high-density lipoprotein cholesterol concentrations took 2 years to normalise in 80% of patients, interleukin-6 decreased significantly in relation to baseline only after 2 years from BS (p < 0.001), and tumour necrosis factor alpha concentrations did not significantly decrease during the 2 years of follow-up. Plasma ghrelin concentrations increased in both surgical groups compare to baseline during the first year (24.6% in modified RYGBP and 36.62% in ringed RYGBP) and remained stable at the second year of follow-up, with no statistical differences between groups.

Conclusions

In the second year of follow-up after BS, morbidity continued to improve in MO patients despite a lesser weight loss in relation to the first year. An increase in plasma ghrelin concentrations was found, regardless of nutrient contact with gastric fundus. Furthermore, changes in plasma ghrelin concentrations appeared to be independent of weight loss.

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Acknowledgements

We thank Miss Christine O’Hara for her help with the manuscript editing. This work has been supported, in part, by a grant from Instituto Carlos III by a Fiss nºPI0201316.

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Authors and Affiliations

  1. General Surgery Department, Hospital Universitari Germans Trias i Pujol, C/Muntanya no. 27–08758 Cervelló, Barcelona, Spain

    Noelia Pérez-Romero

  2. Nephrology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Assumpta Serra & Maruja Navarro-Díaz

  3. Clinical Biochemistry Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Maria Luisa Granada

  4. General Surgery Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Miquel Rull & Antonio Alastrué

  5. Chief of Nephrology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Ramón Romero

  6. Cathedratic of Surgery of Barcelona Autonomous University and Chief of General Surgery Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Jaime Fernández-Llamazares

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  1. Noelia Pérez-Romero
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  2. Assumpta Serra
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Correspondence to Noelia Pérez-Romero.

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Pérez-Romero, N., Serra, A., Granada, M.L. et al. Effects of Two Variants of Roux-en-Y Gastric Bypass on Metabolism Behaviour: Focus on Plasma Ghrelin Concentrations Over a 2-Year Follow-up. OBES SURG 20, 600–609 (2010). https://doi.org/10.1007/s11695-009-0035-0

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