Early Ghrelin and Glp-1 Changes After Sleeve Gastrectomy in Diabetic Obese Patients.


Sleeve Gastrectomy (SG) is associated with a high rate of T2DM resolution. The purpose of this study was to evaluate the early effect of SG on Ghrelin and GLP-1 concetrations.

Between October 2002 and September 2009, 240 obese patients underwent SG. Sixty-eight patients had an altered glucose homeostasis. In 9 T2DM obese patients (6 women and 3 men, age 48.3 ± 7.4 years, BMI 44.7 ± 7.8 kg/m2), during IVGTT performed preoperatively and 60 hours postoperatively to determine insulin sensitivity, basal and at 15 minutes Ghrelin and GLP-1 levels were evaluated. In four of these patients, at one postoperative month, basal and post-prandial hormonal changes were evaluated.

As discussed in a previous abstract the postoperative IVGTT insulin curve was restored to normal in all patients. Ghrelin from a preoperative basal and stimulated values of 81.7±21.4 and 56.4±15.1 pM/L decreased to a postoperative values of 53.1±12.7 and 19.8±9.2 pM/L. GLP-1 from a preoperative basal and stimulated values of 2.1±0.9 and 2.3±0.78 pM/L increased to a postoperative values of 2.6±1.9 and 2.9±0.7 pM/L. These hormonal modifications were confirmed at one postoperative month.

SG determines as expected a reduction of ghrelin values, both basal and after IVGTT. On the contrarypostoperative GLP-1 values wereincreased when compared to pre SG values both in basal conditions and after IVGTT . These changes are independent from the food passage through the gastro-intestinal tract or weight loss. The Ghrelin and GLP-1 changes seem to be directly related to the fundus ablation.

Session: Podium Presentation

Program Number: S061

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