Abstract
Obesity is a significant health issue with an overall rise in mortality; it has multiple risk factors, including hormonal effects, which play a significant role in the balance of food intake and weight gain. Ghrelin is an anabolic hormone secreted from stomach fundus and plays a significant role in this regulation. Management of obesity involves multiple interventions, including lifestyle adjustment, pharmacotherapy, and bariatric surgery. Bariatric embolization is a relatively new procedure; several animal studies show that embolization of the left gastric artery reduces serum ghrelin and induces weight loss. Also, several clinical studies were conducted in the past ten years which have shown bariatric embolization's effectiveness in inducing weight loss: a meta-analysis of 47 patients included in six different clinical studies of left gastric artery embolization resulted in 8% total weight loss from baseline body weight. Many studies also show this procedure's effect on lowering the HgA1C level and lipid profile. Clinical studies mostly reported minor adverse effects such as transient abdominal discomfort, nausea and vomiting, gastric ulcers, and major adverse effects were uncommon, suggesting the procedure is well tolerated. It may be an alternative line of management in patients who are not suitable candidates for bariatric surgery.Although future clinical studies will provide an answer to several questions like the exact effects of the procedure on diabetes and metabolic syndrome, future studies are also needed to establish particular guidelines to match different patient characteristics with their optimal procedural techniques and pre- and post-procedure evaluation tests.
Highlights
Adult obesity is defined as a body mass index (BMI) of 30 kg/m 2 or higher, while BMI of 25 to 29 kg/m 2 is defined as overweight [1]
Ghrelin is an acylated peptide hormone that exists in two forms, namely acylated ghrelin (AG) and unacylated ghrelin Oacyltransferase (GOAT)
Trans-arterial left gastric artery embolization via embolic microspheres leads to local ischemia of the stomach's fundus and suppresses the anabolic hormone function, which decreases appetite and reduces weight
Summary
BackgroundAdult obesity is defined as a body mass index (BMI) of 30 kg/m 2 or higher, while BMI of 25 to 29 kg/m 2 is defined as overweight [1]. The exact cause of obesity is not clear [7], Hormonal effects play a major role in the balance of food intake and weight gain by sending signals to multiple areas in CNS responsible for appetite regulation [8,9]. Ghrelin is an acylated peptide hormone that exists in two forms, namely acylated ghrelin (AG) and unacylated ghrelin Oacyltransferase (GOAT). The latter transfers an acyl group from the fatty acids to the serine-3 residue of ghrelin, which works to stimulate the appetite [12,13]. Ghrelin is mainly secreted by secretory granules of submucosal cells of the fundus of the stomach [15], and its levels can be influenced by multiple factors including diet, lifestyle, exercises, and environment [16]
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