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Fasting and Meal-Induced CCK and PP Secretion Following Intragastric Balloon Treatment for Obesity

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Abstract

Background

Satiety is centrally and peripherally mediated by gastrointestinal peptides and the vagal nerve. We aimed to investigate whether intragastric balloon treatment affects satiety through effects on fasting and meal-stimulated cholecystokinin (CCK) and pancreatic polypeptide (PP) secretion.

Methods

Patients referred for obesity treatment were randomised to 13 weeks of sham treatment followed by 13 weeks of balloon treatment (group 1; sham/balloon) or to twice a 13-week period of balloon treatment (group 2; balloon/balloon). Blood samples were taken for fasting and meal-stimulated CCK and PP levels at the start (T0) and after 13 (T1) and 26 (T2) weeks. Patients filled out visual analogue scales (VAS) to assess satiety.

Results

Forty-two patients (35 females, body weight 125.1 kg, BMI 43.3 kg/m2) participated. In group 1, basal CCK levels decreased but meal-stimulated response remained unchanged after 13 weeks of sham treatment. In group 2, basal and meal-stimulated CCK levels decreased after 13 weeks of balloon treatment. At the end of the second 13-week period, when group 1 had their first balloon treatment, they duplicated the initial 13-week results of group 2, whereas group 2 continued their balloon treatment and reduced meal-stimulated CCK release. Both groups showed reduced meal-stimulated PP secretions at T1 and T2 compared to T0. Changes in diet composition and VAS scores were similar. Improvements in glucose homeostasis partly explained the PP results.

Conclusions

The reduced CCK and PP secretion after balloon positioning was unexpected and may reflect delayed gastric emptying induced by the balloon. Improved glucose metabolism partly explained the reduced PP secretion. Satiety and weight loss were not adversely influenced by these hormonal changes.

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Conflict of Interest

Both authors, EMH Mathus-Vliegen and GH de Groot, had no conflicts of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands

    Elisabeth M. H. Mathus-Vliegen

  2. Department of Internal Medicine, Red Cross Hospital, Beverwijk, the Netherlands

    Gerrit H. de Groot

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  1. Elisabeth M. H. Mathus-Vliegen
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  2. Gerrit H. de Groot
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Correspondence to Elisabeth M. H. Mathus-Vliegen.

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Mathus-Vliegen, E.M.H., de Groot, G.H. Fasting and Meal-Induced CCK and PP Secretion Following Intragastric Balloon Treatment for Obesity. OBES SURG 23, 622–633 (2013). https://doi.org/10.1007/s11695-012-0834-6

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