title: Laparoscopic sleeve gastrectomy differentially affects serum concentrations of FGF-19 and FGF-21 in morbidly obese subjects.
abstract: OBJECTIVE
  Fibroblast growth factor (FGF)-19 and FGF-21 are novel metabolic regulators that improve insulin resistance and obesity in rodents. The aim of the study was to assess the effects of laparoscopic sleeve gastrectomy (LSG) on serum concentrations of FGF-19 and FGF-21 along with circulating bile acids and other relevant hormonal and biochemical parameters.
  
  
  METHODS
  Seventeen females with obesity undergoing LSG and 15 lean healthy females were included into the study. Anthropometric and biochemical parameters, serum concentrations of FGF-19 and -21, insulin, adiponectin, leptin, C-reactive protein, resistin, amylin (total), ghrelin (active), glucagon-like peptide 1 (GLP-1, active), glucose-dependent insulinotropic peptide (GIP, total), peptide YY (PYY, total), pancreatic polypeptide (PP), and bile acids, and mRNA expression of selected adipokines and inflammatory markers in bioptic samples of subcutaneous fat were assessed at baseline and 6, 12, and 24 months after LSG.
  
  
  RESULTS
  LSG markedly decreased body weight, BMI, waist circumference, and insulin levels and improved systemic inflammation and lipid levels. FGF-19 concentrations increased and FGF-21 concentrations decreased after LSG along with increased adiponectin and decreased leptin, amylin, and ghrelin levels. GLP-1, GIP, PP, and circulating bile acids were not affected by LSG. PYY decreased significantly 24 months after surgery only. mRNA expression analysis in subcutaneous fat showed markedly reduced proinflammatory state.
  
  
  CONCLUSIONS
  Our results indicate that increased FGF-19 and decreased ghrelin concentrations could have partially contributed to the improvement of systemic inflammation and some metabolic parameters after LSG, while changes of FGF-21 are rather secondary because of weight loss.
authors.affiliation: 3rd Department of Medicine, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic. mhalu@lf1.cuni.cz
authors.forename: D
authors.initials: D
authors.lastname: Haluzíková
authors.forename: Z
authors.initials: Z
authors.lastname: Lacinová
authors.forename: P
authors.initials: P
authors.lastname: Kaválková
authors.forename: J
authors.initials: J
authors.lastname: Drápalová
authors.forename: J
authors.initials: J
authors.lastname: Křížová
authors.forename: M
authors.initials: M
authors.lastname: Bártlová
authors.forename: M
authors.initials: M
authors.lastname: Mráz
authors.forename: T
authors.initials: T
authors.lastname: Petr
authors.forename: L
authors.initials: L
authors.lastname: Vítek
authors.forename: M
authors.initials: M
authors.lastname: Kasalický
authors.forename: M
authors.initials: M
authors.lastname: Haluzík
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood*; D005743:Gastrectomy / Q000379:methods*; D005749:Gastric Inhibitory Polypeptide / Q000097:blood; D054439:Ghrelin / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D058228:Islet Amyloid Polypeptide / Q000097:blood; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D010191:Pancreatic Polypeptide / Q000097:blood; D019894:Peptide YY / Q000097:blood; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism; D052243:Resistin / Q000097:blood; D050151:Subcutaneous Fat / Q000378:metabolism; D055105:Waist Circumference; D015431:Weight Loss
chemical_list: D052242:Adiponectin; D001647:Bile Acids and Salts; C117476:FGF19 protein, human; D054439:Ghrelin; D007328:Insulin; D058228:Islet Amyloid Polypeptide; D020738:Leptin; D012333:RNA, Messenger; D052243:Resistin; C414620:fibroblast growth factor 21; D019894:Peptide YY; D005749:Gastric Inhibitory Polypeptide; D010191:Pancreatic Polypeptide; D005346:Fibroblast Growth Factors; D052216:Glucagon-Like Peptide 1; D002097:C-Reactive Protein