Impact of gut hormone FGF-19 on type-2 diabetes and mitochondrial recovery in a prospective study of obese diabetic women undergoing bariatric surgeryReportar como inadecuado

Impact of gut hormone FGF-19 on type-2 diabetes and mitochondrial recovery in a prospective study of obese diabetic women undergoing bariatric surgery - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Medicine

, 15:34

First Online: 16 February 2017Received: 06 October 2016Accepted: 18 January 2017DOI: 10.1186-s12916-017-0797-5

Cite this article as: Martinez de la Escalera, L., Kyrou, I., Vrbikova, J. et al. BMC Med 2017 15: 34. doi:10.1186-s12916-017-0797-5


BackgroundThe ileal-derived hormone, fibroblast growth factor 19 FGF-19, may promote weight loss and facilitate type-2 diabetes mellitus remission in bariatric surgical patients. We investigated the effect of different bariatric procedures on circulating FGF-19 levels and the resulting impact on mitochondrial health in white adipose tissue AT.

MethodsObese and type-2 diabetic women n = 39, BMI > 35 kg-m undergoing either biliopancreatic diversion BPD, laparoscopic greater curvature plication LGCP, or laparoscopic adjustable gastric banding LAGB participated in this ethics approved study. Anthropometry, biochemical, clinical data, serum, and AT biopsies were collected before and 6 months after surgery. Mitochondrial gene expression in adipose biopsies and serum FGF-19 levels were then assessed.

ResultsAll surgeries led to metabolic improvements with BPD producing the greatest benefits on weight loss ↓30%, HbA1c ↓28%, and cholesterol ↓25% reduction, whilst LGCP resulted in similar HbA1c improvements adjusted for BMI. Circulating FGF-19 increased in both BPD and LGCP χ2 = 8.088; P = 0.018, whilst, in LAGB, FGF-19 serum levels decreased P = 0.028. Interestingly, circulating FGF-19 was inversely correlated with mitochondrial number in AT across all surgeries n = 39. In contrast to LGCP and LAGB, mitochondrial number in BPD patients corresponded directly with changes in 12 of 14 mitochondrial genes assayed P < 0.01.

ConclusionsElevated serum FGF-19 levels post-surgery were associated with improved mitochondrial health in AT and overall diabetic remission. Changes in circulating FGF-19 levels were surgery-specific, with BPD producing the best metabolic outcomes among the study procedures BPD > LGCP > LAGB, and highlighting mitochondria in AT as a potential target of FGF-19 during diabetes remission.

KeywordsGut hormone FGF-19 Mitochondria Type-2 diabetes recovery Obesity Bariatric surgery AbbreviationsATadipose tissue

BPDbiliopancreatic diversion

COX4I1cytochrome c oxidase subunit 4 isoform 1 Complex IV

DRP1dynamin-1-like protein

FGF-19fibroblast growth factor 19

FIS1mitochondrial fission 1 protein

LAGBlaparoscopic adjustable gastric banding

LGCPlaparoscopic greater curvature plication

MFN2mitofusin 2

mtATP6mtDNA-encoded ATP synthase subunit 6 Complex V

mtDNAmitochondrial DNA

mtND6mtDNA-encoded NADH-ubiquinone oxidoreductase chain 6 Complex II

OPA1optic atrophy 1

PGC1αperoxisome proliferator-activated receptor γ coactivator 1 α

POLGmitochondrial DNA polymerase gamma

SDHAsuccinate dehydrogenase complex II subunit A

SOD1superoxide dismutase 1

TFAMmitochondrial transcription factor A

UCP2uncoupling protein 2

Autor: Lucia Martinez de la Escalera - Ioannis Kyrou - Jana Vrbikova - Voitech Hainer - Petra Sramkova - Martin Fried - Milan K. 


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