Opioid-like peptides and ghrelin mitigation of sleeve gastrectomy results depends on obesity level.

Abstract

INTRODUCTION\nBariatric surgery, as the only effective treatment of obesity, has strong effects on the metabolism, nervous and endocrine systems. Thus, based on the different opinions on the efficaciousness of morbid obesity treatments, the aim of the present study was to estimate the association of serum ghrelin and Met-enkephalins (native, five amino acids and cryptic, precursor of enkephalin) concentrations with BMI value in bariatric patients within 30 postoperative days.\n\n\nMATERIAL AND METHODS\nStudy were performed on 38 female patients divided into two groups: I.BMI lower than 40 kg/m2 (n=18) and II. BMI higher than 40 kg/m2 (n=20). Blood was taken before (-24h), 72 h and 30 days after the sleeve gastrectomy. Routine hematologic, anthropometric and metabolic parameters as well as TSH, ghrelin and Met-enkephalins values were measured in all patients.\n\n\nRESULTS\nThere were statistically significant differences between two groups before the surgery in terms of TSH, both forms of Met-enkephalin, triglycerides concentrations, activity of ALT, GGTP and CRP. After 72 h, the serum levels of cryptic Met-enkephalin, CRP and activity of enzymes varied between the two groups of patients. Thirty days after the surgery, some metabolic and immune parameters were still different in both female groups in favour of patients with lover BMI. However, significant differences were noticed in the levels of ghrelin (increase), native (decrease) and cryptic Met-enkephalins (increase).\n\n\nCONCLUSIONS\nThe activity of endogenous peptides in bariatric patients is connected with the obesity degree. Ghrelin level increases are negatively correlated with native Met-enkephalin changes shortly after bariatric surgery. The interplay of ghrelin and opioids might be consider as a predictor of postoperative weight loss success.