Ghrelin and Leptin Changes Post-Sleeve Gastrectomy

Background: Ghrelin and leptin may regulate metabolism and appetite. Ghrelin, a newly discovered orexigenic gastric hormone, is produced when the stomach is empty. This may explain why morbidly obese people fail to diet, hence the recommendation for bariatric surgery. Leptin, a well-known adipokine, inhibits food intake and circulates at fat-mass-related levels. Aim of the study: To evaluate changes in the ghrelin and leptin level post-laparoscopic sleeve gastrectomy. And their relation to changes in appetite and weight loss. Methods: This prospective study examines adult patients' clinical and lab data for pre- and post-sleeve gastrectomy at Al-Hussain Medical City and Al-Kafeel Hospital in Karbala. The study included 48 obese individuals (36 females and 12 males) with a mean age of 35.5 ± 8.9 years and a BMI of 42.4 ± 5.6 kg/m2. Clinical data comprised pre-surgery body weight, height, hunger, and ghrelin and leptin levels. Patients were seen 2–5 months following surgery for follow-up. Results: Significant decreases in plasma ghrelin (p<0.0001) and leptin (p<0.0001) were detected. Patients reported a considerable appetite reduction post-surgery (p <0.0001). Serum ghrelin (p = 0.0004) and leptin (p = 0.003) decreased significantly compared to hunger fluctuations following surgery. The average patient weight loss was 20.2 kg, and excess weight loss was 36.4 ± 10.8%. All patients achieved an 8 kg/m2 weight loss and a 46 ±16.6% excess weight loss while controlling comorbidities such as diabetes, hypertension, and sleep apnea. Conclusion: Significant reduction in ghrelin and leptin levels post-surgery. Significant correlation between decrease in ghrelin and leptin concentrations and decrease in appetite post sleeve gastrectomy.