The aim of the study is to precise the effect of a large amount of weight loss induced by gastric bypass on the endocannabinoid system (plasma and adipose tissue) of morbidly obese patients and to determine the influence of a gastric bypass surgery compared to a lifestyle intervention with equivalent weight loss on the endocannabinoid system
Dysregulation of the endocannabinoid system has been associated with the development of obesity, metabolic and cardiovascular disorders in both animals and humans. Obese patients, especially those with abdominal obesity, have significantly higher levels of endocannabinoids. No influence of moderate (5%) body weight loss (induced either by diet intervention or sibutramine) on the peripheral activity of the endocannabinoid system gastric bypass (GB) surgery is the most efficient treatment of obesity Hormonal pathways may participate to the weight reducing effect of the procedure.The endocannabinoid system is present in the gastrointestinal tract. In animals, sustained weight loss after GB is characterized by reduction of endocannabinoids levels. The endocannabinoid levels will be studied (baseline and after stimulation) in: * Normal-weight subjects * Obese subjects before and after gastric bypass surgery * Obese subjects before and after a lifestyle intervention
Study Type
OBSERVATIONAL
Enrollment
44
The evaluation of the endocannabinoid system consist in the determination of plasma concentration of the 2 main endocannabinoids (2AG and AEA) before (5 blood samples) and after (5 blood samples) after consumption of a calibrated food. As a comparator, ghrelin will be measured at the same time.
The endocannabinoids will be also determined in adipose tissue. Biopsy of visceral and peripheral adipose tissue will be done during surgery and peripheral adipose tissue will be done 6 months after surgery.
Haut Lévêque Hospital, Endocrine department
Pessac, France
Plasmatic endocannabinoïd concentration variation
Time frame: Inclusion and 6 month-follow up
Plasma concentration of the endocannabinoids during food exposure
Time frame: At each visit
Post prandial pic of the plasma concentration of the endocannabinoids
Time frame: At each visit
Adipose tissue concentration of the endocannabinoids
Time frame: Inclusion and 6 month-follow up
Plasma concentration of adipokines
Time frame: At each visit
Body mass index
Time frame: At each visit
Body composition
Time frame: At each visit
Insulin sensitivity
Time frame: At each visit
Area under the curve of plasma concentration of 2AG
Time frame: Inclusion and 6 month follow-up
Questionaries scores
Time frame: At each visit
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The evaluation of the metabolic status consist in evaluation of body composition (DEXA), determination of visceral adiposity (CT scan) and measurement of plasma lipids, glucose, insulin, leptin, adiponectin.
The behavioral evaluation will de done with different questionnaires: ORWELL 97, HAD scale, Three Factor Eating Questionnaire, Beck Depression inventory, Questionnaire of personality TCI.
The evaluation of the metabolic status will also be seen by a dietician.
The behavioural evaluation will de done with a psychologist consultation