Key result
Gastric bypass significantly increased plasma pro-NT/NMN levels from 246.3 to 748.3 pmol/liter over 24 months (P<0.01), whereas levels remained stable after gastric banding and in controls.
Why the study?
Does bariatric surgery (gastric bypass or banding) alter proneurotensin levels in morbidly obese patients?
Observational (n=20)
No
Does bariatric surgery (gastric bypass or banding) alter proneurotensin levels in morbidly obese patients?
Gastric bypass, but not gastric banding, significantly increases plasma proneurotensin levels in morbidly obese patients, suggesting distinct effects of different bariatric procedures on gastrointestinal hormone metabolism.
Answers are grounded in this paper and cite their sources.
Gastric bypass-associated pro-NT rise may distinguish procedure-specific metabolic effects; leaves open neurotensin's role in outcomes.
CONTEXT: Neurotensin is produced mainly in the N cells of the ileum and has a role in appetite regulation; levels are decreased in obese subjects and increase after bariatric surgery. Mature neurotensin is very unstable, with a short half-life. OBJECTIVE: The objective of this study was to compare baseline and postoperative levels of the more stable neurotensin precursor, proneurotensin/neuromedin (pro-NT/NMN), in patients after gastric banding, gastric bypass, and nonoperated controls, respectively, during long-term follow-up. DESIGN AND SETTING: This was a prospective observational study in a university hospital. PARTICIPANTS AND MAIN OUTCOME MEASURES: Overnight fasting plasma pro-NT/NMN concentrations were measured with a new sandwich immunoassay in morbidly obese subjects at baseline and 6, 12, and 24 months after gastric banding (n = 8), Roux-en-Y gastric bypass (n = 5), and in nonoperated controls (n = 7). RESULTS: After gastric bypass and banding, body weight decreased by (mean +/- sd) 29.5 +/- 5.5 and 22.8 +/- 5.9 kg, respectively. The decrease after 3 and 6 months was more pronounced after gastric bypass compared with gastric banding (P < 0.05). Plasma pro-NT/NMN levels in patients after gastric bypass increased from 246.3 +/- 174.3 pmol/liter on admission to 748.3 +/- 429.6 pmol/liter after 24 months (P < 0.01). In contrast, in patients with gastric banding, pro-NT/NMN concentrations remained stable (207.3 +/- 60.5 pmol/liter at admission, 226.6 +/- 116.8 pmol/liter after 24 months). Neither body weight nor plasma pro-NT/NMN levels changed in nonoperated controls. CONCLUSION: Plasma pro-NT/NMN levels show a more pronounced increase after gastric bypass compared with gastric banding, suggesting that specific bariatric surgical procedures result in distinct alterations of gastrointestinal hormone metabolism. The more stable precursor pro-NT/NMN provides a new tool to quantify neurotensin levels in clinical practice.
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Christ‐Crain et al. (2006) conducted an observational in Morbid obesity (n=20). Gastric bypass and gastric banding vs. Nonoperated controls was evaluated on Overnight fasting plasma pro-NT/NMN concentrations (p=<0.01). Gastric bypass significantly increased plasma pro-NT/NMN levels from 246.3 to 748.3 pmol/liter over 24 months (P<0.01), whereas levels remained stable after gastric banding and in controls.
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