Gastric Banding Research Today is a free monthly online journal that collates and summarizes the latest research about Gastric Banding, including details on laparoscopic gastric banding, stomach stapling, gastric bypass, risks, diet. | ||||||||
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Growth Hormone and Insulin-Like Growth Factor-I deficiency are associated with reduced loss of fat mass after laparoscopic- adjustable silicone gastric banding.Di Somma C, Angrisani L, Rota F, Savanelli MC, Cascella T, Belfiore A, Orio F, Lombardi G, Colao A, Savastano S Department of Molecular and Clinical Endocrinology and Oncology, Division of Endocrinology, University Federico II of Naples, via S. Pansini 5, 80131 Naples, Italy. Context: GH secretion is reduced in obese subjects and increases after body weight loss. It is still unclear if changes in the GH/IGF-I axis after laparoscopic-adjustable silicone gastric banding (LASGB) are associated with changes of body composition. Objective: To analyze the relationships between changes in the GH/IGF-I axis and those of body weight and composition before and after LASGB. Design: Observational, prospective. Setting: University "Federico II" of Naples (Italy). Patients: Seventy-two females severely obese (BMI: 44.9+/-4.68; mean age: 33.1+/-11.34 yrs) were studied. Main outcome measures: GH peak after GHRH plus arginine test, IGF-I, IGFBP-3 and ALS levels, fat mass (FM) and of free fat mass (FFM) (by Bioelectrical Impedance Analysis) at baseline and 6 months after LASGB. The percent change of individual variables was calculated as well as that of excess of body weight lost (EBWL%). The FM%, FFM% and EBWL% were correlated with peak GH and IGF-I levels changes. Results: At baseline, GH deficiency (GHD) (GH peak </=4.1 mug/liter) was found in 22 patients (31%), 16 of them also had IGF-I deficiency (<-2SDS). IGF-I levels were inversely correlated with waist circumference (r=-0.72, p<0.001) and FM% (r=-0.75, p<0.001). Post-LASGB the patients were classified as follows: group 1) GH and IGF-I sufficient (n=44; 61.1%); group 2) GH and IGF-I deficient (n=14; 19.4%) and group 3) GH sufficient and IGF-I deficient (n=14; 19.4%). Percent changes of EWBL (p<0.05, p=0.051; respectively) and FM (p<0.001, p<0.01; respectively) were lower in groups 2 and 3 than in group 1. At the stepwise linear regression analysis, post-operative IGF-I levels were the strongest determinant of percent changes of FM (p<0.0001), of FFM (p=0.009) and of EBWL (p<0.0001). Conclusions: IGF-I levels is the most sensitive to unfavourable changes in body composition 6 months after LASGB making investigation of the somatotropic axis useful in the evaluation of bariatric surgery outcomes. Published 15 January 2008 in Clin Endocrinol (Oxf).
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