Sleeve Gastrektomi Yapılan Obez Kadınlarda Serum Ghrelin Düzeyinin ve Beslenme Durumunun Değerlendirilmesi
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Neşe, A. Assessment of Serum Ghrelin Level and Nutritional Status in Obese Women with Sleeve Gastrectomy. Hacettepe University, Graduate School of Health Sciences, Nutritional Sciences Programme, M.Sc. Thesis, Ankara, 2019. The aim of this study is conducted to evaluate serum ghrelin levels, nutrition and emotional status of obese women undergoing sleeve gastrectomy. Thirty volunteer women aged between 20-50 years who underwent sleeve gasterectomy operation at Lokman Hekim Akay Hospital and Memorial Ankara Hospital were included in the study. The anthropometric measurements, serum biochemical parameters, nutrition status by FFQ (Food frequency questionnaire), eating behaviors by Three Factor Eating Scale (TFEQ-Tr21), depression levels by Beck Depression Inventory and total serum ghrelin levels measured using the ELISA method were evaluated at preoperative and postoperative 3rd month. The mean body mass index (BMI) of the subjects was significantly lower in the postoperative 3rd month (preop: 40.16±5.01 kg/m2, postop: 32.47±5.04 kg/m2) (p<0.001). It was determined that the average consumption of chocolate and chocolate products, pastry and biscuits, sugar and sugar products decreased significantly after surgery (p<0.001). The mean consumption of chips, hamburger and pizza, french fries decreased significantly postoperatively (p<0.001). Serum ghrelin levels decreased in the postoperative 3rd month (preop:1125.85±1010.74 pg/mL, postop:51.33±118.54 pg/mL) (p <0.001). There was no significant relationship between serum ghrelin levels and cognitive restriction (p= 0.230), emotional eating (p=0.391), uncontrolled eating behavior (p= 0.803) and depression levels (p=0.856) (p>0.05). There was a positive moderate correlation between uncontrolled eating behavior and BMI (r = 0.466 p = 0.009) (p <0.05). No correlation was found between serum ghrelin level and diet and average energy, carbohydrate, protein and fat intake (p>0.05). There was a moderate correlation between uncontrolled eating behaviors and daily average energy intake (r = 0.441 p = 0.015), emotional eating behavior and carbohydrate intake (r=0.436, p=0.016) (p<0.05). In conclusion, there was no relationship between decreased serum ghrelin levels and nutritional and emotional states after sleeve gastectomy. However, the tendency of healthy eating behavior increased after sleeve gastrectomy. In order to prevent weight gain in the long term, it is thought to be beneficial that follow healthy nutrition recommendations in multidisciplinary approach.