Dynamics of the Eating Behavior Hormone Levels Leptin andчGhrelin in Patients with Gastroesophageal Reflux Disease Depending on the Treatment Strategy
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16116Keywords:
Gastroesophageal Reflux Disease, Laparoscopic Fundoplication, Eating Behavior, Ghrelin, LeptinAbstract
The aim of the work: to assess leptin and ghrelin levels in patients with gastroesophageal reflux disease, to assess their dynamics and to determine their relationship with body mass index.
Materials and Methods. The study included the examination and treatment of 90 patients with gastroesophageal reflux disease (GERD). Laparoscopic total fundoplication in a modification of the Short Floppy Nissen technique was performed in 35 patients. Drug therapy was prescribed to 35 patients. The comparison group consisted of 20 healthy volunteers. The groups of patients and healthy control subjects were matched for gender and age. Venous blood for the study was collected from patients in the comparison group, and in the groups before and after surgical or therapeutic treatment, as well as from all patients 2–3 months after treatment. Ghrelin (Ghrelin, ELISA, BMS2192, Ebioscience) and leptin (Leptin, Sensitiv ELISA, KAC2281, Ebioscience) were tested on the ImmunoChem-2100 enzyme-linked immunosorbent assay (ELISA) (USA).
Results. The median ghrelin level in healthy participants was 21.2 ng/mL [5.44; 22.7], leptin 0.8 ng/mL [0.22; 1.5], and body mass index (BMI) 21 kg/m² [18; 25]. In healthy volunteers, a strong positive correlation was observed between leptin levels and BMI (r=0.666, p=0.001). The correlation between ghrelin and leptin (r=-0.373, p=0.105) and between ghrelin and BMI (r=-0.296, p=0.206) was not statistically significant. Significant differences were found in concentrations of the metabolic hormones leptin and ghrelin, as well as in BMI, in patients with GERD compared to healthy volunteers. Changes in these parameters were also observed after surgical and therapeutic treatment. A positive correlation between leptin concentration and BMI was established in all groups. Patients had increased leptin levels and decreased ghrelin levels before surgery and before the start of therapy compared to the control group. After surgery, there was a significant increase in ghrelin levels compared to preoperative levels, while leptin concentrations decreased. A moderate negative correlation was found between ghrelin levels and BMI after therapeutic treatment. Correlation analysis demonstrated a consistent relationship between leptin and BMI in all study groups. The contribution of ghrelin to body weight regulation appeared to be more context-dependent, varying depending on the stage of treatment and the patient's energy status.
Conclusions. Patients with gastroesophageal reflux disease have an increased leptin levels and decreased ghrelin levels. The consistent association between leptin and body mass index in all groups confirms its key role as a marker of adipose tissue, while the greater variability of ghrelin indicates its sensitivity to changes in energy balance and to the effects of treatment. The more pronounced hormonal dynamics observed after surgery compared with therapeutic treatment suggests that antireflux surgery may affect not only reflux mechanisms but also metabolic regulation.
References
Thalheimer A, Bueter M. Excess Body Weight and Gastroesophageal Reflux Disease. Visceral medicine. 2021; 37(4):267-72. DOI: 10.1159/000516050. DOI: https://doi.org/10.1159/000516050
Ahmed SK, Mohammed RA. Obesity: Prevalence, causes, consequences, management, preventive strategies and future research directions. Metabolism open. 2025; 27:100375. DOI: 10.1016/j.metop.2025.100375 DOI: https://doi.org/10.1016/j.metop.2025.100375
Asgari R, Caceres-Valdiviezo M, Wu S, Hamel L, Humber BE, Agarwal SM, Fletcher PJ, Fulton S, Hahn MK, Pereira S. Regulation of energy balance by leptin as an adiposity signal and modulator of the reward system. Molecular metabolism. 2025; 91:102078. DOI: 10.1016/j.molmet.2024.102078 DOI: https://doi.org/10.1016/j.molmet.2024.102078
Mendes C, Carvalho M, Bravo J, Martins S, Raimundo A. Possible Interaction Between Physical Exercise and Leptin and Ghrelin Changes Following Roux-en-Y Gastric Bypass in Sarcopenic Obesity Patients-A Pilot Study. Nutrients. 2024; 16(22):3913. DOI: 10.3390/nu16223913. DOI: https://doi.org/10.3390/nu16223913
Sitar-Tǎut AV, Cozma A, Fodor A, Coste SC, Orasan OH, Negrean V, Pop D, Sitar-Tǎut DA. New Insights on the Relationship between Leptin, Ghrelin, and Leptin/Ghrelin Ratio Enforced by Body Mass Index in Obesity and Diabetes. Biomedicines. 2021; 9(11):1657. DOI: 10.3390/biomedicines9111657. DOI: https://doi.org/10.3390/biomedicines9111657
Allan VJ. Basic immunofluorescence. Protein localization by fluorescence microscopy: a practical approach. Oxford University Press, United Kingdom. 2000; 1-26. DOI: https://doi.org/10.1093/oso/9780199637416.003.0001
Monti V, Carlson JJ, Hunt SC, Adams TD. Relationship of ghrelin and leptin hormones with body mass index and waist circumference in a random sample of adults. Journal of the American Dietetic Association. 2006; 106(6):822-30. DOI: 10.1016/j.jada.2006.03.015. DOI: https://doi.org/10.1016/j.jada.2006.03.015
Młynarska E, Bojdo K, Bulicz A, Frankenstein H, Gąsior M, Kustosik N, Rysz J, Franczyk B. Obesity as a Multifactorial Chronic Disease: Molecular Mechanisms, Systemic Impact, and Emerging Digital Interventions. Current issues in molecular biology. 2025; 47(10):787. DOI: 10.3390/cimb47100787. DOI: https://doi.org/10.3390/cimb47100787
Terra X, Auguet T, Guiu-Jurado E, Berlanga A, Orellana-Gavaldà JM, Hernández M, Sabench F, Porras JA, Llutart J, Martinez S, Aguilar C, Del Castillo D, Richart C. Long-term changes in leptin, chemerin and ghrelin levels following different bariatric surgery procedures: Roux-en-Y gastric bypass and sleeve gastrectomy. Obesity surgery. 2013; 23(11):1790-98. DOI: 10.1007/s11695-013-1033-9. DOI: https://doi.org/10.1007/s11695-013-1033-9
Anastasiou IA, Kounatidis D, Rebelos E, Vallianou NG, Tentolouris A, Tentolouris N, Dalamaga M, Karampela I. Hormonal Alterations in Individuals with Obesity After Metabolic Bariatric Surgery: A Narrative Review. Medicina. 2025; 61(10):1724. DOI: 10.3390/medicina61101724. DOI: https://doi.org/10.3390/medicina61101724
Jagric T. The Contribution of the Hunger Hormone Leptin in the Aetiology of Postoperative Anorexia after Laparoscopic and Open Gastrectomy in Gastric Cancer Patients. Biomolecules. 2021; 11(11):1601. DOI: 10.3390/biom11111601. DOI: https://doi.org/10.3390/biom11111601
Nikolic M, Boban M, Ljubicic N, Supanc V, Mirosevic G, Pezo Nikolic B, Krpan R, Posavec L, Zjacic-Rotkvic V, Bekavac-Beslin M, Gacina P. Morbidly obese are ghrelin and leptin hyporesponders with lesser intragastric balloon treatment efficiency: ghrelin and leptin changes in relation to obesity treatment. Obesity surgery. 2011; 21(10):1597-604. DOI: 10.1007/s11695-011-0414-1. DOI: https://doi.org/10.1007/s11695-011-0414-1
Perakakis N, Farr OM, Mantzoros CS. Leptin in Leanness and Obesity: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2021; 77(6):745-60. DOI: 10.1016/j.jacc.2020.11.069. DOI: https://doi.org/10.1016/j.jacc.2020.11.069
Sun X, Liu B, Yuan Y, Rong Y, Pang R, Li Q. Neural and hormonal mechanisms of appetite regulation during eating. Frontiers in nutrition. 2025; 12: 1484827. DOI: 10.3389/fnut.2025.1484827. DOI: https://doi.org/10.3389/fnut.2025.1484827
Obradovic M, Sudar-Milovanovic E, Soskic S, Essack M, Arya S, Stewart AJ, Gojobori T, Isenovic ER. Leptin and Obesity: Role and Clinical Implication. Frontiers in endocrinology. 2021; 12:585887. DOI: 10.3389/fendo.2021.585887. DOI: https://doi.org/10.3389/fendo.2021.585887
Verdeş G, DuŢă CC, Popescu R, MituleŢu M, Ursoniu S, Lazăr OF. Correlation between leptin and ghrelin expression in adipose visceral tissue and clinical-biological features in malignant obesity. Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie. 2017; 58(3): 923-29.
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