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RYGB-induced weight loss alters postprandial FGF21 metabolism
Postprandial fibroblast growth factor 21 metabolism is uniquely affected by Roux-en-Y gastric bypass-induced weight loss, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Samuel Klein, MD, of the Center for Human Nutrition at Washington University School of Medicine in St. Louis, and colleagues evaluated adults with obesity who underwent Roux-en-Y gastric bypass (RYGB; n = 16) or laparoscopic adjustable gastric band (LAGB; n = 12) to determine whether weight loss induced by surgery increases postprandial plasma fibroblast growth factor 19 (FGF19) and FGF21 concentrations.
Before surgery and after 20% weight loss, glucose kinetics and plasma FGF19 and FGF21 responses to a mixed-meal ingestion and to glucose-insulin infusion during a hyperinsulinemic-euglycemic clamp (HECP) procedure with stable isotope tracer methods were evaluated.
RYGB induced weight loss resulted in an earlier and greater postprandial peak increase in plasma glucose and insulin concentrations compared with LAGB-induced weight loss. Early postprandial suppression of endogenous glucose production rate was not affected by either surgery. After weight loss, mean basal plasma FGF19 was greater in both groups, whereas mean basal plasma FGF21 did not change. Total postprandial plasma FGF19 increased with both surgeries. Compared with LAGB, RYGB causes an earlier peak increase in plasma FGF19 concentration (P < .05).
Insulin-stimulated glucose disposal increased by 60% during the HECP with weight loss in both groups. Plasma FGF19 concentrations before and after surgery-induced loss were not affected by glucose and insulin infusion during the HECP. Before surgery, plasma FGF21 concentration nearly doubles during glucose and insulin infusion during HECP, and after surgery-induced weight loss, FGF21 concentration increased about threefold.
“These findings demonstrate that the alterations in FGF21 metabolism after meal consumption should be considered part of the constellation of unique postprandial metabolic adaptations that occur after RYGB, which also include higher peaks in plasma glucose and insulin, as well as glucagon-like peptide 1, peptide YY and bile acid concentrations,” the researchers wrote. “Additional studies are needed to determine the physiological and clinical implications of RYGB-induced alterations in FGF21 metabolism.” – by Amber Cox
Disclosure: Klein reports being a shareholder of Aspire Bariatrics.