The Impact of Sleeve Gastrectomy as compared to Adjustable Gastric Band on Active and Total Ghrelin and other GI Hormones and their influence on Satiety and Hunger

Abstract

Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric procedure that has been proposed as a potential definitive treatment for morbid obesity. The mechanism of action of LSG remains unclear, but may include increased restriction to meal portion size, alterations in gastric emptying or increased satiety related to alterations in serum ghrelin (endogenous orexigenic hormone) or other active endogenous satiety hormones. Initial reports have suggested that LSG produces dramatic reductions in hunger and augmented satiety. However, the data on the effect of this procedure on satiety hormones and their influence on satiety and hunger are still limited. This project is a cross-sectional study of 30 matched obese patients following LSG (10), Laparoscopic Adjustable Gastric Banding (LAGB) and obese controls. Satiety hormones and satiety scores were analyzed after a standardized test meal. The result of this work showed that both active and total ghrelin were lower following LSG as compared to LAGB. Also, both PYY and GLP-1 were higher in the LSG cohort. These changes were associated with an improved satiety scores suggesting that LSG is a metabolic procedure that affects multiple gut hormones in a favorable way.