Abstrakt

Changes in resting metabolic rate and orexigenic hormones after laparoscopic gastric band surgery

Oscar J L Mitchell, Elizabeth Weinshel, Christine Ren-Fielding, Holly Lofton, George Fielding, Bradley Schwack, Andrew Boxer, Deborah L Chua*

Introduction: Knowledge regarding the effects of laparoscopic adjustable gastric banding (LAGB) on resting metabolic rate (RMR) and the hormonal milieu is limited. Our study aimed to determine how LAGB impacts RMR and hormonal response to a meal. Methods: Twenty-five patients were enrolled. Patients were seen before and two months after surgery. At each visit, RMR was measured and blood was collected fasting and after drinking Ensure to measure hormonal levels including glucagon-like peptide 1, gastric inhibitory polypeptide, peptide YY, ghrelin, pancreatic polypeptide, leptin, insulin and amylin. Results: Of the 25 patients, 17 completed the study, 1 completed RMR only, and 7 dropped out. Mean weight loss was 12.3 kg ± 4.9 and mean percentage of excess BMI loss was 22.6% ± 9.9. Median RMR before and after LAGB decreased significantly. Decrease in RMR correlated with amount of weight loss. Median fasting leptin and ghrelin levels decreased pre- and post-LAGB, but ghrelin did not reach significance. No differences were seen in hormonal response to a meal. Conclusion: Weight loss after LAGB resulted in decreased RMR, fasting leptin levels and possibly lowered ghrelin. Further studies are needed to delineate the long-term effects of LAGB on metabolic rate and the hormonal milieu.