Modulation of appetite- and metabolism-regulating hormones after bariatric embolization, sleeve gastrectomy, and gastric plication.

Objective. The obesity is associated with profound disturbances in appetite-regulating and metabolic hormones including ghrelin, leptin, adiponectin, resistin, and insulin. Bariatric arterial embolization (BEA) has recently emerged as a minimally invasive alternative to established bariatric procedures. However, comparative endocrine evidence remains limited. The aim of the study was to assess postoperative changes in key metabolic and appetite-regulating hormones following laparoscopic sleeve gastrectomy (LSG), laparoscopic gastric plication (LGP), and bariatric embolization of the gastric arteries (BEA). Methods. A total of 76 patients with obesity (BMI >35 kg/m²) were assigned to LSG (n=32), LGP (n=37), or BEA (n=7). Serum concentrations of total ghrelin, leptin, adiponectin, resistin, insulin, and HbA1c were measured preoperatively 3 and 6 months after intervention using standardized ELISA assays. Statistical significance was set at p<0.05. Results. All procedures resulted in significant improvements in hormonal and metabolic profiles within 6 months. Total ghrelin decreased by 55.6% after LGP, 69.7% after LSG, and 74.5% after BEA at 6 months (all p<0.001). Leptin significantly declined, while adiponectin increased in all groups with the most pronounced early (3-month) rise after BEA (+36.1%, p=0.033). Resistin, insulin, and HbA1c progressively decreased across all interventions indicating improved insulin sensitivity. Overall, BEA demonstrated the strongest early hormonal response, whereas long-term (6-month) effects were comparable across procedures. Conclusion. Laparoscopic gastric plication, sleeve gastrectomy, and bariatric embolization provide substantial improvements in appetite-regulating and metabolic hormones in patients with obesity. BEA shows a particularly favorable early endocrine profile supporting its potential as a minimally invasive metabolic intervention.