Abstract
BackgroundBariatric surgery is an effective treatment for severe obesity. It also ameliorates diabetes independently of weight loss through mechanisms that are not fully understood. In this study, we investigated the levels of GH, IGF-1 and IGF-binding protein 2 (IGFBP-2) after gastric sleeve surgery in healthy obese individuals.MethodThis study was conducted in 33 obese (BMI > 38.3) healthy male subjects aged 25 to 50 years undergoing sleeve gastrectomy. GH, IGF-1 and IGFBP-2 levels were evaluated by ELISA at baseline and 6–12 months after surgery. Other parameters, such as glucose, BMI, insulin, HOMA-IR and lipid profile, were also investigated.ResultsSystemic GH (12.32 vs. 50.97 pg/mL, p < 0.001) and IGFBP-2 levels (51.86 vs. 68.81 pg/mL, p < 0.001) were elevated after bariatric surgery. There was no change in IGF-1 level from before to after surgery. BMI (52.18 vs. 40.11, p = 0.001), insulin (19.35 vs. 8.80 mIU/L, p < 0.001) and HOMA-IR index (6.48 to 2.52, p < 0.001) were reduced after surgery. Lipid profile analysis revealed that total cholesterol (4.26 vs. 5.12 mmol/L, p < 0.001) and high-density lipoprotein (HDL) (0.90 to 1.55 mmol/L, p < 0.001) were increased, while triglycerides were decreased, after surgery (1.62 vs. 1.05 mmol/L p < 0.001). GH, IGF-1, and IGFBP-2 were not correlated with insulin or lipid parameters.ConclusionsOur study suggests that improved circulating GH and IGFBP-2 levels may mediate the beneficial effects of gastric sleeve surgery in improving insulin sensitivity and reducing insulin demand.
Highlights
Bariatric surgery is an effective treatment for severe obesity
Lipid profile analysis revealed that total cholesterol (4.26 vs. 5.12 mmol/L, p < 0.001) and high-density lipoprotein (HDL) (0.90 to 1.55 mmol/L, p < 0.001) were increased, while triglycerides were decreased, after surgery (1.62 vs. 1.05 mmol/L p < 0.001)
Growth hormone (GH), insulin-like growth factor 1 (IGF-1), and IGF-binding protein 2 (IGFBP-2) were not correlated with insulin or lipid parameters
Summary
Bariatric surgery is an effective treatment for severe obesity. It ameliorates diabetes independently of weight loss through mechanisms that are not fully understood. According to WHO estimates, in 2016, more than 650 million people are obese, and 1.9 billion people are overweight [1] It is associated with an increased risk of many chronic diseases, including type 2 diabetes (T2D), hypertension, and cardiovascular disease (CVD). GH is produced by the anterior pituitary gland in response to growth hormone–releasing hormone (GHRH), which is released by the hypothalamus as a normal reflection of multiple features, such as hypoglycaemia, low free fatty acids in the blood, high amino acids, good exercise and sleep [2] All these features are diminished in adult subjects with high BMI [3]. Following an increase in BMI, GH secretion is reduced, and lipid metabolism is disturbed, leading to
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