title: Acute post-bariatric surgery increase in orexin levels associates with preferential lipid profile improvement.
abstract: BACKGROUND
  Orexin is a recently identified neuropeptide hormone.
  
  
  OBJECTIVE
  Acute and long-term post-bariatric changes in Orexin and relationship to post-operative metabolic outcomes.
  
  
  METHODS
  Men and women undergoing biliopancreatic diversion with duodenal switch bariatric surgery (n = 76, BMI≥35 kg/m(2)) were evaluated for body composition and plasma parameters at baseline, acutely (1 and 5 days) and long-term (6 and 12 months) post-surgery.
  
  
  METHODS
  University Hospital Centre, Canada.
  
  
  METHODS
  Groups were subdivided based on acute (average 1 and 5 day) changes in Orexin prior to weight loss: (i)>10% Orexin decrease (n = 33, OrexinDEC) and (ii)>10% Orexin increase (n = 20, OrexinINC), to evaluate impact on long-term changes.
  
  
  RESULTS
  Both groups had comparable preoperative Orexin levels, BMI, age, sex distribution, diabetes and lipid lowering medication, plasma glucose and lipid parameters except for apolipoproteinB (p<0.007). Orexin increase was rapid and maintained throughout one year, while OrexinDEC subjects remained significantly lower throughout. Over 12 months, changes in BMI, fat mass, and %fat mass were comparable. Fasting glucose and insulin increased immediately 1-day post-operatively, decreasing rapidly (5-day) and declining thereafter with the OrexinINC group remaining lower than the OrexinDEC group throughout (p = 0.001). Similarly, plasma cholesterol, triglyceride, LDL-C and HDL-C decreased at 1-day, increased slightly (5-day), except HDL-C, then decreased over 1 year, with greater decreases in OrexinINC group relative to OrexinDEC group.
  
  
  CONCLUSIONS
  Rapid postoperative increases in plasma Orexin are associated with better improvement of glucose and lipid profiles following bariatric surgery.
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada ; Department of Physiology, King George's Medical University, Lucknow, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Miegueu
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Lapointe
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada ; Faculté de pharmacie, Université Laval, Québec, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada ; Faculté de pharmacie, Université Laval, Québec, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Martin
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada ; Faculté de pharmacie, Université Laval, Québec, Canada.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Bastien
authors.affiliation: Department of Physiology, King George's Medical University, Lucknow, India.
authors.forename: Sunita
authors.initials: S
authors.lastname: Tiwari
authors.affiliation: Centre de Recherche Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Cianflone
mesh_terms: D000328:Adult; D001055:Apolipoproteins B / Q000097:blood; D050110:Bariatric Surgery; D001786:Blood Glucose; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein; D005260:Female; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins / Q000097:blood*; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009479:Neuropeptides / Q000097:blood*; D000068797:Orexins; D011184:Postoperative Period; D012307:Risk Factors; D013997:Time Factors
chemical_list: D001055:Apolipoproteins B; D001786:Blood Glucose; D047908:Intracellular Signaling Peptides and Proteins; D008055:Lipids; D009479:Neuropeptides; D000068797:Orexins; D002097:C-Reactive Protein