eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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vol. 13
Bariatric surgery
Original paper

Fasting and postprandial acyl and desacyl ghrelin and the acyl/desacyl ratio in obese patients before and after different types of bariatric surgery

Jolanta A. Dardzińska, Łukasz Kaska, Monika Proczko-Stepaniak, Maria Szymańska-Gnacińska, Ewa Aleksandrowicz-Wrona, Sylwia Małgorzewicz

Videosurgery Miniinv 2018; 13 (3): 366–375
Online publish date: 2018/05/21
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The mechanism underlying beneficial outcomes of bariatric surgery still remains unclear. Especially little is known about hormonal and metabolic changes induced by the novel bariatric procedure mini gastric bypass (MGB).

To evaluate pre- and post-prandial changes in both ghrelin isoforms in obese patients without diabetes and cardiovascular complications treated with MGB, sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) surgery.

Material and methods
From 45 patients initially enrolled in the study, 23 persons completed a one-year follow-up period. Venous blood for acyl and desacyl ghrelin (AG and DAG) as well as other metabolic assays was collected 3 months before and 6 and 12 months after bariatric surgery (MGB, RYGB, SG) – in the fasting state and 2 h after the consumption of a standard 300 kcal-mixed meal (Nutridrink standard, Nutricia).

AG and DAG levels (both fasting and prandial) as well as AG/DAG ratio did not change after 6 and 12 months in MGB and RYGB groups. In the SG group we observed a significant decrease in fasting and postprandial DAG levels and consecutively an increase in the fasting AG/DAG ratio after 6 and 12 months. Six months after surgery we observed some differences between carbohydrate metabolism measures in the MGB group (lower HbA1c, HOMA-IR and fasting insulinaemia) in comparison to the rest of the participants, but 12 months after each type of surgery body mass index and indices of carbohydrate and lipid metabolism did not differ.

The results of our study demonstrate that all studied bariatric procedures can successfully reduce overall body weight and suggest also that the mechanisms of weight loss and improvement in carbohydrate and lipid metabolism after all three types of surgery are independent of ghrelin and the acyl/desacyl ghrelin ratio.


acyl ghrelin, desacyl ghrelin, acyl/desacyl ratio, post-prandial, obesity, bariatric, mini gastric bypass

Wren AM, Seal LJ, Cohen MA, et al. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 2001; 86: 5992.
Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002; 346: 1623-30.
Delhanty PJ, van der Lely AJ. Ghrelin and glucose homeostasis. Peptides 2011; 32: 2309-18.
Delhanty PJ, Neggers SJ, van der Lely AJ. Mechanisms in endocrinology. Ghrelin: the differences between acyl- and des-acyl ghrelin. Eur J Endocrinol 2012; 167: 601-8.
Erdmann J, Töpsch R, Lippl F, et al. Postprandial response of plasma ghrelin levels to various test meals in relation to food intake, plasma insulin, and glucose. J Clin Endocrinol Metab 2004; 89: 3048-54.
Dardzińska JA, Małgorzewicz S, Kaska Ł, et al. Fasting and postprandial acyl and desacyl ghrelin levels in obese and non-obese subjects. Endokrynol Pol 2014; 65: 377-81.
Barazzoni R, Zanetti M, Ferreira C, et al. Relationships between desacylated and acylated ghrelin and insulin sensitivity in the metabolic syndrome. J Clin Endocrinol Metab 2007; 92: 3935-40.
Kuppens RJ, Delhanty PJ, Huisman TM, et al. Acylated and unacylated ghrelin during OGTT in Prader-Willi syndrome: support for normal response to food intake. Clin Endocrinol (Oxf) 2016; 85: 488-94.
Victorzon M. Single-anastomosis gastric bypass: better, faster, and safer? Scand J Surg 2015; 104: 48-53.
Janik MR, Stanowski E, Paśnik K. Present status of bariatric surgery in Poland. Videosurgery Mininv 2016; 11: 22-5.
Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg 2014; 24: 1749-56.
Kaska L, Sledzinski T, Chomiczewska A, et al. Improved glucose metabolism following bariatric surgery is associated with increased circulating bile acid concentrations and remodeling of the gut microbiome. World J Gastroenterol 2016; 22: 8698-19.
Yousseif A, Emmanuel J, Karra E, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg 2014; 24: 241-52.
Malin SK, Kashyap SR. Differences in weight loss and gut hormones: Rouen-Y gastric bypass and sleeve gastrectomy surgery. Curr Obes Rep 2015; 4: 279-86.
Dardzińska JA, Kaska Ł, Wiśniewski P, et al. Fasting and post-prandial peptide YY levels in obese patients before and after mini versus Roux-en-Y gastric bypass. Minerva Chir 2017; 72: 24-30.
Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC); European Association for the Study of Obesity (EASO); European Association for the Study of Obesity Obesity Management Task Force (EASO OMTF). Obes Surg 2014; 24: 42-55.
Kaska Ł, Proczko M, Wiśniewski P, et al. A prospective evaluation of the influence of three bariatric procedures on insulin resistance improvement. Should the extent of undiluted bile transit be considered a key postoperative factor altering glucose metabolism? Videosurgery Miniinv 2015; 10: 213-28.
Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-9.
Tymitz K, Engel A, McDonough S, et al. Changes in ghrelin levels following bariatric surgery: review of the literature. Obes Surg 2011; 21: 125-30.
Kalinowski P, Paluszkiewicz R, Wróblewski T, et al. Ghrelin, leptin, and glycemic control after sleeve gastrectomy versus Roux-en-Y gastric bypass-results of a randomized clinical trial. Surg Obes Relat Dis 2017; 13: 181-8.
Fong AK, Wong SK, Lam CC, Ng EK. Ghrelin level and weight loss after laparoscopic sleeve gastrectomy and gastric mini-bypass for Prader-Willi syndrome in Chinese. Obes Surg 2012; 22: 1742-5.
Musella M, Milone M, Leongito M, et al. The mini-gastric bypass in the management of morbid obesity in Prader-Willi syndrome: a viable option? J Invest Surg 2014; 27: 102-5.
Barazzoni R, Zanetti M, Nagliati C, et al. Gastric bypass does not normalize obesity-related changes in ghrelin profile and leads to higher acylated ghrelin fraction. Obesity (Silver Spring) 2013; 21: 718-22.
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