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LSG and fasting levels

LSG allows early changes in the fasting levels

Three months after the procedure the fasting levels of ghrelin, GLP-1, glucagon, leptin, PAI-1, and NEFA were all significantly decreased compared to the pre-operative baseline levels

Laparoscopic sleeve gastrectomy (LSG) has subtle differences from other malabsorptive bariatric operations, demonstrated by the significant early changes in the fasting levels of factors thought to be important regulators of obesity and metabolic health, according to researchers from the University of Notre Dame, Vincent’s Centre for Applied Medical Research and the Garvan Institute of Medical Research.

The study, ‘Effect of Laparoscopic Sleeve Gastrectomy on Fasting Gastrointestinal, Pancreatic, and Adipose-Derived Hormones and on Non-Esterified Fatty Acids’, published in Obesity Surgery, examined the effect of LSG on fasting plasma levels of selected hormones and on non-esterified fatty acids (NEFA) on 11 obese patients, and compared these to levels in 22 non-obese control individuals.

The results showed that LSG resulted in significant reductions in weight, BMI and fasting glucose following LSG, and three months after the procedure the fasting levels of ghrelin, GLP-1, glucagon, leptin, PAI-1, and NEFA were all significantly decreased compared to the pre-operative baseline levels. There were non-significant decreases in C-peptide, insulin, and resistin and a non-significant increase in GIP.

After LSG induced weight loss, patients had significantly lower levels of ghrelin (p<0.001), NEFA (p=0.01), PAI-1 (p<0.001), and resistin (p=0.002), compared to non-obese control individuals. Of these, ghrelin and resistin were significantly lower pre-LSG but decreased further after LSG, and NEFA and PAI-1 had not been significantly different in pre-LSG patients compared to non-obese controls.

Of the factors that were higher pre-LSG compared to non-obese control individuals (insulin, C-peptide, leptin), C-peptide (p=0.042) became significantly higher whereas insulin (p=0.06) and leptin (p=0.95) levels returned to similar ranges to non-obese control levels and glucagon remained not significantly different (p=0.28).

“A remarkable finding of this study was that at only 12 weeks after LSG, the plasma levels of all the six factors that had significantly decreased following surgery were lower than the levels present in non-obese control individuals,” the authors write. “…This study may thus provide insights into the molecular mechanisms that contribute to the beneficial effects of LSG and how these mechanisms differ from those reported for other bariatric operations.”

“Our results suggest that mechanism of action of LSG may differ from operations such as RYGB,” the authors conclude. “Elucidating the molecular benefits of LSG and other bariatric operations offers the prospect of bariatric surgery that is tailored to each individual as well as the hoped-for development of less invasive treatment options.”

The article was edited from the original article, under the Creative Commons license. To access the article, please click here

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