IGF1 modifications after bariatric surgery in morbidly obese patients: potential implications of nutritional status according to specific surgical technique.
OBJECTIVE
IGF1 is decreased in morbidly obese (MO) patients and its changes after bariatric surgery weight loss (WL) are not well known. The aim of this study was to analyse IGF1 modifications in MO patients after WL and its relationship to ghrelin and to different types of surgeries.


METHODS
Retrospective follow-up study at the University Medical Center.


METHODS
One hundred and nine MO patients (age 44.19.3, BMI 51.748.75KG/M(2)) were evaluated at baseline and 1 year after surgery: 28 sleeve gastrectomy (SG), 31 distal modified (m), and 50 ringed (r) Roux-en-Y gastric bypass (RYGBP) surgery. Changes in IGF1, IGFBP3, ratio IGF1:IGFBP3, and ghrelin were evaluated 1 year after surgery.


RESULTS
Baseline prevalence of low IGF1 (defined by s.d. IGF1<-2) was 22%, and %WL 1 year after surgery was 34.9±8.9%. There was a significant decrease in IGFBP3 in all the procedures, an increase in IGF1:IGFBP3 ratio in rRYGBP and SG, but total IGF1 only increased significantly in SG. Albumin concentrations decreased in mRYGBP, did not change in rRYGBP, but increased in SG after surgery. Total ghrelin concentrations increased after both RYGBPs and decreased after SG (P<0.05 in all cases). The prevalence of low IGF1 decreased in SG (28.6 vs 10.1%, P=0.03) and did not change in RYGPBP techniques. The %albumin change was the only dependent variable associated with the % total IGF1 change.


CONCLUSIONS
Recovery of low IGF1 after bariatric surgery was specifically related to the albumin modifications induced by surgery and was not related to ghrelin modifications.
Endocrinology and Nutrition Service, Department of Internal Medicine.
Silvia
S
Pellitero
María Luisa
ML
Granada
Eva
E
Martínez
Jose María
JM
Balibrea
Elena
E
Guanyabens
Assumpta
A
Serra
Pau
P
Moreno
Maruja
M
Navarro
Ramon
R
Romero
Antonio
A
Alastrué
Manel
M
Puig-Domingo
D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D054439:Ghrelin / Q000097:blood; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D016017:Odds Ratio; D011446:Prospective Studies; D012044:Regression Analysis; D012709:Serum Albumin / Q000378:metabolism
D054439:Ghrelin; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D008055:Lipids; D012709:Serum Albumin; D007334:Insulin-Like Growth Factor I