Changes in ghrelin isoforms after sleeve gastrectomy or gastric plication and their association with adiposity and...

Sleeve gastrectomy (SG) and gastric plication (GP) are two widely performed bariatric techniques reducing the size of the stomach. The improvements observed following these procedures are not fully explained only by caloric restriction. Thus, we aimed at the analysis of adiposity and metabolism modifications in diet-induced obesity (DIO) rats submitted to SG or GP and correlate the changes with total ghrelin concentrations and its two different ghrelin isoforms.

Adiposity, lipolysis and circulating ghrelin isoforms were determined in 191 male Wistar rats submitted to surgery: sham (SO), SG, or GP. Results were compared with pair-fed (PF) controls fed either a normal diet (ND) or a high-fat diet (HFD).

DIO rats submitted to SG had significantly lower (p < .05) levels of desacyl ghrelin (DAG) and total ghrelin compared with SO and PF ones. Furthermore, they achieved a greater weight loss, adiposity and improvement in glucose and lipid metabolism, as well as brown adipose tissue mitochondrial morphology. No decrease in ghrelin concentrations was observed in GP.

The differential effect on circulating ghrelin concentrations of SG and GP, despite both procedures reducing actual stomach size, probably underlies the better outcomes on weight control and lipolysis of the SG due to the fundus removal, the main site of ghrelin-producing cells.