위 절제범위에 따른 혈장 그렐린 농도
Plasma Ghrelin Level According to Extent of Gastric Resection
김현열, 전태용, 김동헌, 심문섭, 이상엽, 김윤진, 김형회, 손한철,
소속 상세정보
김현열 ( Kim Hyun-Yul )
부산대학교 의과대학 외과학교실
전태용 ( Jeon Tae-Yong )
부산대학교 의과대학 외과학교실
김동헌 ( Kim Dong-Heon )
부산대학교 의과대학 외과학교실
심문섭 ( Sim Mun-Sup )
부산대학교 의과대학 외과학교실
이상엽 ( Lee Sang-Yeoup )
부산대학교 의과대학 가정의학교실
김윤진 ( Kim Yun-Jin )
부산대학교 의과대학 가정의학교실
김형회 ( Kim Hyung-Hoi )
부산대학교 의과대학 진단검사의학교실
손한철 ( Son Han-Chul )
부산대학교 의과대학 진단검사의학교실
KMID : 0371320040660040307
Abstract
Purpose: Total gastrectomy is followed by weight loss in the majority of patients, but the reason for this is not clear. Ghrelin, a novely isolated gastric hormone, exerts orexigenic activity. If a circulating ghrelin participates in the adaptive response to weight loss, the weight loss induced by total gastrectomy may be accompanied by impaired ghrelin secretion.
Methods: The blood was collected from gastric cancer patients who have undergone gastric resection, preoperatively and immediately after resection, on the 1st, 3rd and 7th postoperative day. The correlation of the preoperative plasma ghrelin concentration with gender, age and BMI were analyzed. The concentration changes of plasma ghrelin were observed serially after dividing gastrectomized patients into the subtotal gastrectomy group, the total gastrectomy group, and the proximal gastrectomy group.
Results: Although statistically not significant, the plasma ghrelin concentration was negatively correlated with age and BMI. In the subtotal gastrectomy group, nadir ghrelin was 48.4±23.6% of the preoperative value after gastric resection and then gradually increased to 82.4±19.9% on the 7th postoperative day. In the total gastrectomy group, nadir ghrelin was 36.9±10.4% of the preoperative value after gastric resection and remained 20.9±10.9% on the 7th postoperative day. In the proximal gastrectomy group, nadir ghrelin was 29.4±4.6% after gastric resection, which was followed by a gradual recovery. However, the recovery rate was steadier than compare to the subtotal gastrectomy group, as the concentration was 41.8±23.1% even on 7th postoperative day.
Conclusion: The principal site of the ghrelin synthesis is stomach which contributes 60~70% to the circulating concentration of ghrelin. In the case of subtotal gastrectomy, ghrelin production is compensated by the remnant stomach. For this reason total gastrectomy is associated with suppressed ghrelin levels and it possibly contribute to the weight loss.
키워드
그렐린;위암;위절제술;Ghrelin;Gastric neoplasm;Gastrectomy
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