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 analyse 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 severely obese females (BMI: 44·9 ± 4·68; mean age: 33·1 ± 11·34 years) were studied. Main outcome measures GH peak after GHRH plus arginine test, IGF-I, IGFBP-3 and ALS levels, fat mass (FM) and free fat mass (FFM) (by Bioelectrical Impedance Analysis) at baseline and 6 months after LASGB. The change in percentage of individual variables was calculated as well as that of excess of body weight loss (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 μg/l) 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%). The percentage 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, postoperative IGF-I levels were the strongest eterminant 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 comatotropic axis useful in the evaluation of bariatric surgery outcomes.

Role of dehydroepiandrosterone sulfate levels on body composition after laparoscopic adjustable gastric banding in pre-menopausal morbidly obese women / Savastano, Silvia; Belfiore, Anna; Guida, Bruna; Angrisani, Luigi; ORIO JR, F.; Cascella, T.; Micanti, F.; Saldalamacchia, G.; Lombardi, Gaetano; Colao, Annamaria. - In: JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION. - ISSN 0391-4097. - STAMPA. - Jun;28(6):(2005), pp. 509-515. [10.1007/bf03347238]

Role of dehydroepiandrosterone sulfate levels on body composition after laparoscopic adjustable gastric banding in pre-menopausal morbidly obese women.

SAVASTANO, SILVIA;BELFIORE, ANNA;GUIDA, BRUNA;ANGRISANI, LUIGI;T. CASCELLA;F. MICANTI;G. SALDALAMACCHIA;LOMBARDI, GAETANO;COLAO, ANNAMARIA
2005

Abstract

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 analyse 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 severely obese females (BMI: 44·9 ± 4·68; mean age: 33·1 ± 11·34 years) were studied. Main outcome measures GH peak after GHRH plus arginine test, IGF-I, IGFBP-3 and ALS levels, fat mass (FM) and free fat mass (FFM) (by Bioelectrical Impedance Analysis) at baseline and 6 months after LASGB. The change in percentage of individual variables was calculated as well as that of excess of body weight loss (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 μg/l) 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%). The percentage 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, postoperative IGF-I levels were the strongest eterminant 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 comatotropic axis useful in the evaluation of bariatric surgery outcomes.
2005
Role of dehydroepiandrosterone sulfate levels on body composition after laparoscopic adjustable gastric banding in pre-menopausal morbidly obese women / Savastano, Silvia; Belfiore, Anna; Guida, Bruna; Angrisani, Luigi; ORIO JR, F.; Cascella, T.; Micanti, F.; Saldalamacchia, G.; Lombardi, Gaetano; Colao, Annamaria. - In: JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION. - ISSN 0391-4097. - STAMPA. - Jun;28(6):(2005), pp. 509-515. [10.1007/bf03347238]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/200936
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