Abstract
BACKGROUND: Bariatric surgery affects multiple physiological systems, including the regulation of des-acyl ghrelin (DAG). DAG has been negatively associated with excess adiposity and insulin resistance. OBJECTIVES: To assess the relationship between serum DAG concentrations and short-term weight loss following bariatric surgery. SETTING: Prospective multicenter cohort study across three bariatric surgery centers in Latvia. METHODS: Fasting blood samples for DAG measurement were collected 1 day preoperatively, 2 days postoperatively, and at 3 months post-surgery. Anthropometric and laboratory assessments were performed at the same time points. RESULTS: A total of 62 patients were included; 64.5% (n = 40) underwent Roux-en-Y gastric bypass (RYGB), and 35.5% (n = 22) sleeve gastrectomy (SG). The cohort was predominantly female (67.7%). Median baseline weight and BMI were 129 kg (IQR 106-150) and 45.1 kg/m2, respectively. Median excess weight loss at 3 months was 40.2% (IQR 32.2-54.3%). DAG concentrations showed significant inverse correlations with preoperative weight (r = -0.371), BMI (r = -0.311), and excess weight (r = -0.355; all P < 0.05). These associations persisted across all sampling points in the RYGB group, whereas in SG patients, they were largely confined to postoperative day 2. No significant relationships were observed between DAG and relative weight-loss metrics. DAG levels were higher in females; age showed no association with DAG changes. CONCLUSION: DAG levels are inversely associated with absolute measures of adiposity, particularly among RYGB patients. These findings support DAG's potential relevance as a marker of total fat burden and early postoperative metabolic response.