Document Detail


Implantable gastric stimulator does not prevent the increase in plasma ghrelin levels that occurs with weight loss.
MedLine Citation:
PMID:  21681227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The SHAPE (Screened Health Assessment and Pacer Evaluation) trial was a 24 month randomized multicenter placebo-controlled study to determine the efficacy of an implantable gastric stimulator (IGS) for weight loss. This report is an investigator-initiated sub-study at one site designed to assess whether IGS affects plasma levels of ghrelin and peptide YY (PYY). The device was implanted in all subjects but was activated in the Treatment group (n = 7, BMI = 41.5 ± 2.0 kg/m2) and remained inactive in the Control (n = 6, BMI = 39.5 ± 1.7 kg/m2) during the first 12 months. IGS was activated in both groups during months 12-24. Fasting venous blood was drawn at months 0, 12, and 24 and an oral glucose tolerance test (OGTT) was performed at month 12. Although there was no difference in weight loss at 6 months (Control: -6.6 ± 1.5% vs. Treatment: -6.2 ± 1.4%), at 24 months the Control group exhibited weight gain from baseline (+2.2 ± 1.5%) that was significantly different from the weight loss in the Treatment group (-1.9 ± 1.4%; P < 0.05). At 12 months, fasting ghrelin was significantly increased (P < 0.05) in the Treatment group (285 ± 35 to 336 ± 35 pg/ml; weight change, -4.9 ± 1.4%), but not in the Control (211 ± 36 to 208 ± 35 pg/ml; weight change, -3.4 ± 1.5%). No significant change was observed in postprandial suppression of plasma ghrelin or in fasting and postprandial PYY levels. In conclusion, IGS does not prevent the increase in fasting plasma ghrelin levels associated with weight loss. Further studies are needed to determine whether changes in technology can improve weight loss and maintenance, perhaps using gut hormones as biomarkers of possible efficacy.
Authors:
Judith Korner; Anindita Nandi; Suzanne M Wright; Jonathan Waitman; Donald J McMahon; Marc Bessler; Louis J Aronne
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obesity (Silver Spring, Md.)     Volume:  19     ISSN:  1930-739X     ISO Abbreviation:  Obesity (Silver Spring)     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-28     Completed Date:  2012-03-27     Revised Date:  2012-08-13    
Medline Journal Info:
Nlm Unique ID:  101264860     Medline TA:  Obesity (Silver Spring)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1935-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Columbia University College of Physicians & Surgeons, New York, New York, USA. jk181@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Double-Blind Method
Electric Stimulation*
Electrodes, Implanted
Fasting
Female
Ghrelin / blood*
Glucose Tolerance Test
Humans
Male
Middle Aged
Obesity, Morbid / blood,  therapy*
Peptide YY / blood
Postprandial Period
Weight Gain
Weight Loss / physiology*
Young Adult
Grant Support
ID/Acronym/Agency:
R01DK 072011/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Ghrelin; 106388-42-5/Peptide YY

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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