Effects of the intragastric balloon MedSil on weight loss, fat tissue, lipid metabolism, and hormones involved in energy balance

Marek Bužga, Machytka Evžen, Klvaňa Pavel, Kupka Tomáš, Zavadilová Vladislava, Zonča Pavel, Zdeněk Svagera, Marek Bužga, Machytka Evžen, Klvaňa Pavel, Kupka Tomáš, Zavadilová Vladislava, Zonča Pavel, Zdeněk Svagera

Abstract

Background: The prevalence of obesity continues to increase worldwide. Because obesity is associated with a number health-related problems as well as a shortened life span, treating obesity is an important clinical concern. Although various treatments are currently available, many are not efficacious in the long term. Therefore, additional medical treatment options for morbidly obese individuals must be explored. In this study, we examined the effects of the intragastric balloon MedSil on anthropometric measures and hormones associated with lipid and energy metabolism.

Methods: Twenty-two obese patients underwent insertion of the intragastric balloon MedSil following a clinical exam, body composition scan, and collection of blood samples. Six months following implantation of the balloon, additional anthropometric and serological measures were taken.

Results: Six months following insertion of the MedSil balloon, we observed significant decreases in body weight, body mass index, and fat mass. Compared with baseline levels, ghrelin serum levels were increased significantly, while leptin, FGF21, and glycated hemoglobin levels significantly decreased, 6 months after balloon insertion.

Conclusions: The MedSil intragastric balloon is a safe and effective treatment for morbid obesity, with positive effects on anthropometric measures and lipid metabolism.

Figures

Fig. 1
Fig. 1
The intragastric balloon MedSil® used in endoscopic treatment for morbidly obese patients
Fig. 2
Fig. 2
A system of tubes for saline solution in endoscopic treatment of the intragastric balloon MedSil®

References

    1. Obesity and overweight, Factsheet N°311, 2011March [cited 2013 Jul 30]. Available from: .
    1. Ackroyd R, Mouiel J, Chevallier JM, et al. Cost-effectiveness and budget impact of obesity surgery in patients with type-2 diabetes in three European countries. Obes Surg. 2006;16(11):1488–1503. doi: 10.1381/096089206778870067.
    1. Franz MJ, VanWormer JJ, Crain AL, et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007;107(10):1755–1767. doi: 10.1016/j.jada.2007.07.017.
    1. Avenell A, Brown TJ, McGee MA, et al. What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. J Hum Nutr Diet. 2004;17(4):317–335. doi: 10.1111/j.1365-277X.2004.00531.x.
    1. Konopko-Zubrzycka M, Baniukiewicz A, Wróblewski E, et al. The effect of intragastric balloon on plasma ghrelin, leptin, and adiponectin levels in patients with morbid obesity. J Clin Endocrinol Metab. 2009;94(5):1644–1649. doi: 10.1210/jc.2008-1083.
    1. Pinheiro J, Bates D, DebRoy S, et al. (2013). nlme: Linear and nonlinear mixed effects models. R package version 3.1–109.
    1. R Core Team (2013). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL .
    1. Genco A, Cipriano M, Bacci V, et al. BioEnterics intragastric balloon (BIB): a short-term, double-blind, randomised, controlled, crossover study on weight reduction in morbidly obese patients. Int J Obes (Lond). 2006;30(1):129–133. doi: 10.1038/sj.ijo.0803094.
    1. McFarland RJ, Grundy A, Gazet JC, et al. The intragastric balloon: a novel idea proved ineffective. Br J Surg. 1987;74(2):137–139. doi: 10.1002/bjs.1800740222.
    1. Giardiello C, Borrelli A, Silvestri E, et al. Air-filled vs water-filled intragastric balloon: a prospective randomized study. Obes Surg. 2012;22(12):1916–1919. doi: 10.1007/s11695-012-0786-x.
    1. Genco A, Balducci S, Bacci V, et al. Intragastric balloon or diet alone? A retrospective evaluation. Obes Surg. 2008;18(8):989–992. doi: 10.1007/s11695-007-9383-9.
    1. Imaz I, Martínez-Cervell C, García-Alvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18(7):841–846. doi: 10.1007/s11695-007-9331-8.
    1. Dumonceau JM. Evidence-based review of the bioenterics intragastric balloon for weight loss. Obes Surg. 2008;18(12):1611–1617. doi: 10.1007/s11695-008-9593-9.
    1. Crea N, Pata G, Della Casa D, et al. Improvement of metabolic syndrome following intragastric balloon: 1 year follow-up analysis. Obes Surg. 2009;19(8):1084–1088. doi: 10.1007/s11695-009-9879-6.
    1. Sallet JA, Marchesini JB, Paiva DS, et al. Brazilian multicenter study of the intragastric balloon. Obes Surg. 2004;14(7):991–998. doi: 10.1381/0960892041719671.
    1. Evans D, Scott MH. Intragastric balloon in the treatment of patients with morbid obesity. Br J Surg. 2001;88(9):1245–1248. doi: 10.1046/j.0007-1323.2001.01840.x.
    1. Lecumberri E, Krekshi W, Matía P, et al. Effectiveness and safety of air-filled balloon Heliosphere BAG® in 82 consecutive obese patients. Obes Surg. 2011;21(10):1508–1512. doi: 10.1007/s11695-010-0314-9.
    1. Dogan UB, Gumurdulu Y, Akin MS, et al. Five percent weight lost in the first month of intragastric balloon treatment may be a predictor for long-term weight maintenance. Obes Surg. 2013;23(7):892–896. doi: 10.1007/s11695-013-0876-4.
    1. Danielsen KK, Svendsen M, Mæhlum S, et al. Changes in body composition, cardiovascular disease risk factors, and eating behavior after an intensive lifestyle intervention with high volume of physical activity in severely obese subjects: a prospective clinical controlled trial. J Obes. 2013. doi: 10.1155/2013/325464. Epub 2013 Apr 22. PMID: 23710347; PMCID: PMC3654355.
    1. Weck M, Bornstein SR, Barthel A, et al. Strategies for successful weight reduction—focus on energy balance. Dtsch Med Wochenschr. 2012;137(43):2223–2228. doi: 10.1055/s-0032-1327232.
    1. Wycherley TP, Brinkworth GD, Clifton PM, et al. Comparison of the effects of 52 weeks weight loss with either a high-protein or high-carbohydrate diet on body composition and cardiometabolic risk factors in overweight and obese males. Nutr Diabetes. 2012;2:e40. doi: 10.1038/nutd.2012.11.
    1. Sekino Y, Imajo K, Sakai E, et al. Time-course of changes of visceral fat area, liver volume and liver fat area during intragastric balloon therapy in Japanese super-obese patients. Intern Med. 2011;50(21):2449–2455. doi: 10.2169/internalmedicine.50.5672.
    1. Mathus-Vliegen EM, Eichenberger RI. Fasting and Meal-Suppressed Ghrelin Levels Before and After Intragastric Balloons and Balloon-Induced Weight Loss. Obes Surg. 2013 Aug 6. [Epub ahead of print] PMID: 23918282.
    1. Martinez-Brocca MA, Belda O, Parejo J, et al. Intragastric balloon-induced satiety is not mediated by modification in fasting or postprandial plasma ghrelin levels in morbid obesity. Obes Surg. 2007;17(5):649. doi: 10.1007/s11695-007-9109-z.
    1. Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21–34. doi: 10.1111/j.1467-789X.2006.00270.x.
    1. Sahu A. Leptin signaling in the hypothalamus: emphasis on energy homeostasis and leptin resistance. Front Neuroendocrinol. 2003;24(4):225–253. doi: 10.1016/j.yfrne.2003.10.001.
    1. Kojima M, Hosoda H, Date Y, et al. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402(6762):656–660. doi: 10.1038/45230.
    1. Cummings DE, Purnell JQ, Frayo RS, et al. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes. 2001;50(8):1714–1719. doi: 10.2337/diabetes.50.8.1714.
    1. Nikolic M, Boban M, Ljubicic N, et al. Morbidly obese are ghrelin and leptin hyporesponders with lesser intragastric balloon treatment efficiency : ghrelin and leptin changes in relation to obesity treatment. Obes Surg. 2011;21(10):1597–1604. doi: 10.1007/s11695-011-0414-1.
    1. Roubos EW, Dahmen M, Kozicz T, et al. Leptin and the hypothalamo-pituitary-adrenal stress axis. Gen Comp Endocrino. 2012;177(1):28–36. doi: 10.1016/j.ygcen.2012.01.009.
    1. Belgardt BF, Brüning JC. CNS leptin and insulin action in the control of energy homeostasis. Ann N Y Acad Sci. 2010 Nov;1212:97–113. doi: 10.1111/j.1749-6632.2010.05799.x. Epub 2010 Nov 11. Review. PMID: 21070248.
    1. Mion F, Gincul R, Roman S, et al. Tolerance and efficacy of an air-filled balloon in non-morbidly obese patients: results of a prospective multicenter study. Obes Surg. 2007;17(6):764. doi: 10.1007/s11695-007-9141-z.
    1. Iglesias P, Selgas R, Romero S, et al. Biological role, clinical significance, and therapeutic possibilities of the recently discovered metabolic hormone fibroblastic growth factor 21. Eur J Endocrinol. 2012;167(3):301–309. doi: 10.1530/EJE-12-0357.
    1. Reinehr T, Woelfle J, Wunsch R, et al. Fibroblast growth factor 21 (FGF-21) and its relation to obesity, metabolic syndrome, and nonalcoholic fatty liver in children: a longitudinal analysis. J Clin Endocrinol Metab. 2012;97(6):2143–2150. doi: 10.1210/jc.2012-1221.
    1. Zhang X, Yeung DC, Karpisek M, et al. Serum FGF21 levels are increased in obesity and are independently associated with the metabolic syndrome in humans. Diabetes. 2008;57(5):1246–1253. doi: 10.2337/db07-1476.
    1. Mraz M, Bartlova M, Lacinova Z, et al. Serum concentrations and tissue expression of a novel endocrine regulator fibroblast growth factor-21 in patients with type 2 diabetes and obesity. Clin Endocrinol (Oxf) 2009;71(3):369–375. doi: 10.1111/j.1365-2265.2008.03502.x.
    1. Mai K, Schwarz F, Bobbert T, et al. Relation between fibroblast growth factor-21, adiposity, metabolism, and weight reduction. Metabolism. 2011;60(2):306–311. doi: 10.1016/j.metabol.2010.02.016.
    1. Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–568. doi: 10.1016/j.soard.2011.01.044.
    1. Haluzíková D, Lacinová Z, Kaválková P, et al. Laparoscopic sleeve gastrectomy differentially affects serum concentrations of FGF-19 and FGF-21 in morbidly obese subjects. Obesity (Silver Spring) 2013;21(7):1335–1342. doi: 10.1002/oby.20208.
    1. Dastis SN, François E, Deviere J, et al. Intragastric balloon for weight loss: results in 100 individuals followed for at least 2.5 years. Endoscopy. 2009;41(7):575–580. doi: 10.1055/s-0029-1214826.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe