Effect of gastric bypass and gastric banding on proneurotensin levels in morbidly obese patients

被引:44
作者
Christ-Crain, Mirjam
Stoeckli, Rolf
Ernst, Andrea
Morgenthaler, Nils G.
Bilz, Stefan
Korbonits, Marta
Struck, Joachim
Bergmann, Andreas
Mueller, Beat
Keller, Ulrich
机构
[1] St Bartholomews Hosp, Dept Endocrinol, London EC1M 6BQ, England
[2] Univ Basel Hosp, Div Endocrinol Diabet & Clin Nutr, CH-4031 Basel, Switzerland
[3] SphingoTec GmbH, D-16556 Borgsdorf, Germany
[4] BRAHMS AG, Dept Res, D-16761 Hennigsdorf, Germany
关键词
RAT SMALL-INTESTINE; JEJUNOILEAL BYPASS; FOOD-INTAKE; IMMUNOHISTOCHEMICAL LOCALIZATION; BARIATRIC SURGERY; ENDOCRINE-CELLS; NERVOUS-SYSTEM; NEUROTENSIN; GUT; HORMONE;
D O I
10.1210/jc.2006-0256
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: Neurotensin is produced mainly in the N cells of the ileum and has a role in appetite regulation; levels are decreased in obese subjects and increase after bariatric surgery. Mature neurotensin is very unstable, with a short half-life. Objective: The objective of this study was to compare baseline and postoperative levels of the more stable neurotensin precursor, proneurotensin/neuromedin (pro-NT/NMN), in patients after gastric banding, gastric bypass, and nonoperated controls, respectively, during long-term follow-up. Design and Setting: This was a prospective observational study in a university hospital. Participants and Main Outcome Measures: Overnight fasting plasma pro-NT/NMN concentrations were measured with a new sandwich immunoassay in morbidly obese subjects at baseline and 6, 12, and 24 months after gastric banding (n = 8), Roux-en-Y gastric bypass (n = 5), and in nonoperated controls (n = 7). Results: After gastric bypass and banding, body weight decreased by (mean +/- SD) 29.5 +/- 5.5 and 22.8 +/- 5.9 kg, respectively. The decrease after 3 and 6 months was more pronounced after gastric bypass compared with gastric banding (P < 0.05). Plasma pro-NT/NMN levels in patients after gastric bypass increased from 246.3 +/- 174.3 pmol/liter on admission to 748.3 +/- 429.6 pmol/liter after 24 months (P < 0.01). In contrast, in patients with gastric banding, pro-NT/NMN concentrations remained stable (207.3 +/- 60.5 pmol/liter at admission, 226.6 +/- 116.8 pmol/liter after 24 months). Neither body weight nor plasma pro-NT/NMN levels changed in nonoperated controls. Conclusion: Plasma pro-NT/NMN levels show a more pronounced increase after gastric bypass compared with gastric banding, suggesting that specific bariatric surgical procedures result in distinct alterations of gastrointestinal hormone metabolism. The more stable precursor pro-NT/NMN provides a new tool to quantify neurotensin levels in clinical practice.
引用
收藏
页码:3544 / 3547
页数:4
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