Changes In Leptin Level After Different Bariatric Procedures: Gastric Balloon And Sleeve Gastrectomy, And Its Relation To The Effectiveness Of Weight Loss.

Abstract

Background: Obesity can affect the neuroendocrine system in various ways, either by hormonal elevation as in ghrelin and growth hormone or by depression as in the case of leptin and insulin. Leptin has been previously researched in its relation t o the energy homeostasis in obesity, however the effect of various surgical procedures are far from being fully understood. Methods: A prospective multicenter case control study was done including twenty non morbidly obese ( ≤ 40 kg/m 2 ) and morbidly obese (> 40 kg/m 2 )patients treated with IGB (control) or SG with base line and follow up after six months leptin level determination and weight loss assessment. Results: Leptin showed a highly significant (P<0.001) decrease six months after the insertion of the balloon. The mean decline of leptin hormone level was 8 ug/l (+/- 5.06). In the group of sleeve gastrectomy (SG), leptin showed a significant (P<0.05) decrease six months after the operation. The mean decline of leptin hormone level was 17.6 ug/l (+/ - 17.06). There was a statistically significant differe nce between the two groups as regard the weight loss (P<0.05). Conclusion: The effect of different intervention procedures on the neuroendocrine system can give us an important clue to the future of individualized therapy either in the further selection of patients to undertake the most beneficial cost effective procedure or to add adjuvant hormonal therapy to the treatment.