Abstract
Serum bone morphogenic protein- (BMP-) 4 levels are associated with human adiposity. The aim of this study was to investigate changes in serum levels of BMP-4 and inflammatory cytokines after Roux-en-Y gastric bypass (RYGB). Fifty-seven patients with type 2 diabetes underwent RYGB. Serum levels of BMP-4 and various inflammatory markers, including high-sensitivity C-reactive protein (hsCRP), free fatty acids (FFAs), and plasminogen activator inhibitor- (PAI-) 1, were measured before and 12 months after RYGB. Remission was defined as glycated hemoglobin <6.5% for at least 1 year in the absence of medications. Levels of PAI-1, hsCRP, and FFAs were significantly decreased at 1 year after RYGB. BMP-4 levels were also significantly lower at 1 year after RYGB than at baseline (P = 0.024). Of the 57 patients, 40 (70%) had diabetes remission at 1 year after surgery (remission group). Compared with patients in the nonremission group, patients in the remission group had lower PAI-1 levels and smaller visceral fat areas at baseline. There was a difference in the change in the BMP-4 level according to remission status. Our data demonstrate a significant beneficial effect of bariatric surgery on established cardiovascular risk factors and a reduction in chronic nonspecific inflammation after surgery.
Highlights
Bone morphogenic proteins (BMPs) are members of the transforming growth factor-β superfamily
We found that the levels of the inflammatory markers PAI1, high-sensitivity C-reactive protein (hsCRP), and free fatty acids (FFAs) were decreased significantly 1 year after bariatric surgery in severely obese patients with type 2 diabetes mellitus
The serum bone morphogenic protein- (BMP-)4 level was decreased after Roux-en-Y gastric bypass (RYGB), especially in the remission group and tended to be positively correlated with serum plasminogen activator inhibitor- (PAI-)1 and hsCRP levels
Summary
Bone morphogenic proteins (BMPs) are members of the transforming growth factor-β superfamily They were originally identified as bone-inducing proteins, the activities of BMPs are not restricted to bone formation [1]. Activation of BMP4 signaling may be associated with increased adiposity in humans [3]. No studies have investigated the changes in BMP-4 levels in severely obese patients with type 2 diabetes after bariatric surgery. The increase in PAI-1 levels may result partly from the release of International Journal of Endocrinology free fatty acids (FFAs) from fat tissues in diabetic patients, as well as in young nondiabetic individuals [7]. The aim of this study was to investigate changes in the serum levels of BMP-4 and inflammatory cytokines after RYGB in a severely obese population
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