Importance of Ghrelin in metabolic surgery and decreasing its effect by Bypass surgery modification

Zviad Gagua, Vladimer Gonjilashvili


Bariatric surgery is any surgical procedure that is directed toward losing weight. In the 1970s' cases were reported that patients, who had bariatric surgery, developed rapid postoperative remission of type 2 diabetes mellitus. In the 1960s' it was discovered that GI hormones play an important role in insulin secretion and regulation of glycemia. Changes in GI hormone secretion establish a mechanism, which determines the remarkable therapeutic effect of bariatric surgery, leads to weight loss, and controls glycemia. The most important hormone is considered to be Ghrelin. Ghrelin is a peptide of 28 amino acids, which is produced by close type cells of the fundus of the stomach, as well as by enteroendocrine cells of the small intestine, cells of the pancreatic island, neurons of different parts of the brain, including the hypothalamus. Data shows that, since most intensive expression of Ghrelin is in the fundus of the stomach,  the decrease in the concentration of circulating Ghrelin in patients who had various bariatric surgery depends on to what extent is fundus disconnected during surgical procedures and how isolated are Ghrelin producing cells from food, which regulate Ghrelin concentration. Most interesting for our research is Mini-Gastric Bypass. A simplified method of gastric bypass anastomosis with a single anastomosis. The advantages of the Mini-Gastric Bypass procedure, the removal of the fundus during Bypass operations, the associated changes in ghrelin concentration, and ultimately the impact of all this on excess weight loss and glycemic homeostasis, formed the basis of our team's research on the new modification of Bypass procedure. We hope, it will allow us to develop a procedure that will ensure optimal control of weight correction and optimal control of glycemia in the future.

Methods: We used PubMed and Google Scholar as databases of information. Articles were filtered with keywords: Bariatric surgery, Type 2 diabetes mellitus, Ghrelin, Mini-Gastric Bypass.


Keywords: Bariatric surgery, Type 2 diabetes mellitus, Ghrelin, Mini-Gastric Bypass.

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ISSN: 2346-8491 (online)