Circulating Diabetic Candidate Neurotrophic Factors, Brain-Derived Neurotrophic Factor and Fibroblast Growth Factor 21, in Sleeve Gastrectomy

Hung-Hsuan Yen,Ming-Tsan Lin,Chiung-Nien Chen,Po-Chu Lee,Chi-Ling Chen,Po-Jen Yang,Wei-Shiung Yang,Sung-Tsang Hsieh

doi:10.1038/s41598-020-62395-z

Hung-Hsuan Yen, Ming-Tsan Lin + Show 6 more

Open Access

https://doi.org/10.1038/s41598-020-62395-z

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Abstract

Recent studies show brain-derived neurotrophic factor (BDNF) and fibroblast growth factor 21 (FGF21) are neurotrophic factors associated with obesity and diabetes mellitus (DM). Laparoscopic sleeve gastrectomy (LSG) can significantly reduce weight and improve DM. In this study, we enrolled 78 patients with obesity and evaluated the change of BDNF and FGF21 6 months after LSG. At baseline, the BDNF level was similar between the preoperative DM (n = 30) (17.1 ± 7.7 ng/ml) and non-DM (n = 48) (17.0 ± 6.9 ng/ml) patients with obesity, but FGF21 was significantly higher in the DM patients (201.5 ± 204.3 versus 107.6 ± 63.8 pg/ml). At 6 months after LSG, most of the preoperative DM patients (96.7%) had DM either resolved (66.7%) or improved (30%). BDNF increased and FGF21 decreased significantly regardless of the preoperative DM status, while FGF21 decreased more prominently in the preoperative DM patients (−92.6 ± 179.8 versus −4.6 ± 63.4 pg/ml). After adjusted for age, sex, and preoperative DM status, FGF21 became significantly and positively related to C-peptide (β = 18.887), insulin (β = 2.399), and homeostasis model assessment of insulin resistance index (β = 8.566) after surgery. In conclusion, diabetic patients with obesity had higher FGF21 and similar BDNF levels compared to non-diabetic obese patients. BDNF increased and FGF21 decreased significantly after LSG. FGF21 became positively associated with several insulin-related profiles after surgery.

Highlights

brain-derived neurotrophic factor (BDNF) has been shown to decrease appetite, increase energy expenditure, reduce body weight, and improve hyperglycemic conditions through ameliorating hepatic insulin resistance in animal models[17,18]
The current study aimed to investigate the changes in circulating BDNF and fibroblast growth factor 21 (FGF21) with weight reduction and the alleviation of metabolic diseases in morbidly obese patients with or without T2DM 6 months after Laparoscopic sleeve gastrectomy (LSG) and the associations between these two neurotrophic factors and clinical variables before and after LSG
BDNF was similar between the two groups while FGF21 was significantly higher in the preoperative diabetes mellitus (DM) than in the non-DM group (P = 0.020)

Summary

Introduction

BDNF has been shown to decrease appetite, increase energy expenditure, reduce body weight, and improve hyperglycemic conditions through ameliorating hepatic insulin resistance in animal models[17,18]. The secretion of FGF21 is regulated by different dietary composition[24,25,26] and serum bile acids level[25,27], and the increased FGF21 level is addictive to insulin activity to decrease insulin resistance[12,26]. The current study aimed to investigate the changes in circulating BDNF and FGF21 with weight reduction and the alleviation of metabolic diseases in morbidly obese patients with or without T2DM 6 months after LSG and the associations between these two neurotrophic factors and clinical variables before and after LSG

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