Enteroendocrine Cells Before and After Sleeve Gastrectomy

Study Overview
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Brief Summary
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Morbidly obese patients exhibit impaired secretion of satiation hormones which may contribute to the development of obesity. Bariatric surgery is associated with weight loss and dramatic increase in the secretion of satiation hormones, but the underlying mechanism remains unknown. The investigator's goal is therefore to examine patients before and after sleeve gastrectomy and compare findings to lean controls.

Detailed Description
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Morbidly obese patients exhibit impaired secretion of satiation hormones cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1) and peptide YY (PYY), which may contribute to the development of obesity. Bariatric surgery is associated with weight loss and dramatic increase in the secretion of satiation hormones, but the underlying mechanism remains unknown. A better understanding of mechanisms involved will assist in development of non-invasive therapeutic strategies. The investigator's goal is therefore to examine patients before and after sleeve gastrectomy and compare findings to lean controls. Gastric and intestinal mucosa will be collected by endoscopy from morbidly obese subjects before and 3 months after sleeve gastrectomy. In Addition, lean controls will be examined. Expression of various gut peptides will be assessed by immunohistochemistry and quantitative polymerase chain reaction (PCR).

Official Title
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Enteroendocrine Cells in Lean Controls and Healthy Subjects Before and After Sleeve Gastrectomy

Conditions
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Obesity

Intervention / Treatment
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* Procedure: sleeve gastrectomy
* Other: no intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Morbidly obese patients scheduled for sleeve gastrectomy BMI > 35 kg/m2 Age: > 18-65 years Lean, healthy controls BMI > 18 and < 28kg/m2 Age: >18-40 years Exclusion Criteria: Bleeding diathesis Previous surgery on the gastrointestinal tract (appendectomy acceptable)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: sleeve gastrectomy<br>Morbidly obese patients scheduled for sleeve gastrectomy will be examined by endoscopy before and 3 months after surgery. Biopsies will be taken from stomach and duodenum. | Procedure: sleeve gastrectomy<br>* Sleeve gastrectomy is an established form of bariatric (weight reducing) surgery, where the greater curvature of the stomach is removed.<br>|
| Other: no intervention<br>Lean, healthy controls will undergo endoscopy and biopsies will be taken from stomach and duodenum. | Other: no intervention<br>* lean control group<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quantification of the enteroendocrine cell population | Expression of enteroendocrine cell population possessing chromogranin A, ghrelin, CCK, PYY, GLP-1 and GLP-2 by immunohistochemistry and quantitative PCR. | within 3 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determination of tissue morphology (crypt depth, villus height) | Morphometric analysis | within 3 months after surgery |