Opioid-like peptides and ghrelin mitigation of bariatric results depends on obesity level
, 5
Abstract
Introduction: Bariatric surgery, as the only effective treatment of obesity, has strong effects on the metabolism, and nervous and endocrine systems. Thus, based on the different opinions about the efficaciousness of morbid obesity treatments, the aim of the present study was to estimate the association of serum ghrelin and Met-enkephalin (native, five amino acids and cryptic, precursor of enkephalin) concentrations with body mass index (BMI) value in bariatric patients within 30 postoperative days.
Material and methods: The study was performed on 38 female patients divided into two groups: I — BMI lower than 40 kg/m2 (n = 18) and II — BMI higher than 40 kg/m2 (n = 20). Blood was taken before (–24 h), and 72 h and 30 days after the sleeve gastrectomy. Routine haematological, anthropometric, and metabolic parameters as well as thyroid-stimulating hormone (TSH), ghrelin, and Met-enkephalin values were measured in all patients.
Results: There were statistically significant differences between the two groups before the surgery in terms of TSH, both forms of Metenkephalin, triglycerides concentrations, and activity of alanine transaminase (ALT), gamma glutamyltransferase (GGTP), and C-reactive protein (CRP). After 72 h, the serum levels of cryptic Met-enkephalin and CRP, and activity of enzymes varied between the two groups of patients. Thirty days after the surgery, some metabolic and immune parameters were still different in both female groups in favour of patients with lover BMI. However, significant differences were noticed in the levels of ghrelin (increase), and native (decrease) and cryptic Met-enkephalins (increase).
Conclusions: The activity of endogenous peptides in bariatric patients is connected with the degree of obesity. Ghrelin level increases are negatively correlated with native Met-enkephalin changes shortly after bariatric surgery. The interplay of ghrelin and opioids might be considered as a predictor of postoperative weight loss success.
Keywords: opioidsghrelinobesitybariatric surgery
References
- Friedman JM. Obesity in the new millennium. Nature. 2000; 404(6778): 632–634.
- World Health Organization. Report of a WHO Consultation. Obesity: preventing and managing the global epidemic. WHO, Geneva, Switzerland 2000.
- Dyaczyński M, Scanes CG, Koziec H, et al. Endocrine implications of obesity and bariatric surgery. Endokrynol Pol. 2018; 69(5): 574–597.
- Williams KW, Elmquist JK. Lighting up the hypothalamus: coordinated control of feeding behavior. Nat Neurosci. 2011; 14(3): 277–278.
- Dickson SL, Egecioglu E, Landgren S, et al. The role of the central ghrelin system in reward from food and chemical drugs. Mol Cell Endocrinol. 2011; 340(1): 80–87.
- Date Y, Kojima M, Hosoda H, et al. Ghrelin, a novel growth hormone-releasing acylated peptide, is synthesized in a distinct endocrine cell type in the gastrointestinal tracts of rats and humans. Endocrinology. 2000; 141(11): 4255–4261.
- Kojima M, Hosoda H, Date Y, et al. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999; 402(6762): 656–660.
- Pierzchała-Koziec K, Scanes CG, Zubel-Łojek J, et al. Met-enkephalin-like peptides and ghrelin mitigate negative effects of bariatric surgery in rats. Acta Biol Cracovien ser Zool. 2014; 55/56: 100–107.
- Pierzchala K, Van Loon GR. Plasma native and peptidase-derivable Met-enkephalin responses to restraint stress in rats. Adaptation to repeated restraint. J Clin Invest. 1990; 85(3): 861–873.
- Pierzchala-Koziec K, Kepys B. Stress-induced alterations in regional concentrations of native Met-enkephalin in brain are age-dependent. Acta Biol Cracovien ser Zool. 2000; 42: 107–111.
- Pierzchała-Koziec K, Scanes C, Dziedzicka-Wasylewska M, et al. Corticotrophin Releasing Hormone Modulates Morphine Effect on the Met-Enkephalin Activity in the Hypothalamic-Pituitary-Adrenal Axis in Lambs. Folia Biologica (Kraków). 2017; 65(4): 199–212.
- Pierzchała-Koziec K, Dziedzicka-Wasylewska M, Scanes CG. Isolation stress impacts Met-enkephalin in the hypothalamo-pituitary-adrenocortical axis in growing Polish Mountain sheep: a possible role of the opioids in modulation of HPA axis. Stress. 2019; 22(2): 256–264.
- Gosnell BA, Levine AS. Reward systems and food intake: role of opioids. Int J Obes (Lond). 2009; 33(Suppl 2): S54–S58.
- Bodnar RJ, Glass MJ, Ragnauth A, et al. General, mu and kappa opioid antagonists in the nucleus accumbens alter food intake under deprivation, glucoprivic and palatable conditions. Brain Res. 1995; 700(1–2): 205–212.
- Mendez IA, Ostlund SB, Maidment NT, et al. Involvement of Endogenous Enkephalins and β-Endorphin in Feeding and Diet-Induced Obesity. Neuropsychopharmacology. 2015; 40(9): 2103–2112.
- Sirbu AE, Buburuzan L, Kevorkian S, et al. Adiponectin expression in visceral adiposity is an important determinant of insulin resistance in morbid obesity. Endokrynol Pol. 2018; 69(3): 252–258.
- Santos J, Salgado P, Santos C, et al. Effect of bariatric surgery on weight loss, inflammation, iron metabolism, and lipid profile. Scand J Surg. 2014; 103(1): 21–25.
- Titmuss AT, Srinivasan S. Metabolic syndrome in children and adolescents: Old concepts in a young population. J Paediatr Child Health. 2016; 52(10): 928–934.
- Korzeniowska KA, Brzeziński M, Szarejko K, et al. The association of thyroid-stimulating hormone (TSH) and free thyroxine (fT4) concentration levels with carbohydrate and lipid metabolism in obese and overweight teenagers. Endokrynol Pol. 2019; 70(2): 172–178.
- Tiller D, Ittermann T, Greiser KH, et al. Association of Serum Thyrotropin with Anthropometric Markers of Obesity in the General Population. Thyroid. 2016; 26(9): 1205–1214.
- Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012; 22(5): 740–748.
- Rokicka D, Marek B, Kajdaniuk D, et al. Hypoglycaemia in endocrine, diabetic, and internal diseases [Hipoglikemia w schorzeniach endokrynologicznych, diabetologicznych i internistycznych]. Endokrynol Pol. 2019; 70(3): 277–297.
- Ostlund SB, Kosheleff A, Maidment NT, et al. Decreased consumption of sweet fluids in μ opioid receptor knockout mice: a microstructural analysis of licking behavior. Psychopharmacology (Berl). 2013; 229(1): 105–113.
- Wheeler E, Huang Ni, Bochukova EG, et al. Genome-wide SNP and CNV analysis identifies common and low-frequency variants associated with severe early-onset obesity. Nat Genet. 2013; 45(5): 513–517.
- Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med. 2002; 346(21): 1623–1630.
- Andrews ZB. Central mechanisms involved in the orexigenic actions of ghrelin. Peptides. 2011; 32(11): 2248–2255.
- Naznin F, Toshinai K, Waise TM, et al. Restoration of metabolic inflammation-related ghrelin resistance by weight loss. J Mol Endocrinol. 2018; 60(2): 109–118.
- Cabral A, Francesco PDe, Perello M. Brain Circuits Mediating the Orexigenic Action of Peripheral Ghrelin: Narrow Gates for a Vast Kingdom. Front Endocrinol. 2015; 6.
- Banks WA, Burney BO, Robinson SM. Effects of triglycerides, obesity, and starvation on ghrelin transport across the blood-brain barrier. Peptides. 2008; 29(11): 2061–2065.
- Holst B, Cygankiewicz A, Jensen TH, et al. High constitutive signaling of the ghrelin receptor--identification of a potent inverse agonist. Mol Endocrinol. 2003; 17(11): 2201–2210.
- Smith RG, Leonard R, Bailey AR, et al. Growth hormone secretagogue receptor family members and ligands. Endocrine. 2001; 14(1): 9–14.
- Sato T, Ida T, Nakamura Y, et al. Physiological roles of ghrelin on obesity. Obes Res Clin Pract. 2014; 8(5): e405–e413.
