Fibroblast growth factor 21 correlates with weight loss after vertical sleeve gastrectomy in adolescents.
Vertical sleeve gastrectomy (VSG) results in weight loss and increased bile acids (BA) and fibroblast growth factor 19 (FGF19) levels. FGF21 shares essential cofactors with FGF19, but its physiology early post-VSG has not been assessed.



Ten adolescents (17.4 ± 0.5 years and BMI 51.5 ± 2.5 kg/m2) were enrolled. Fasting and postmeal (100 mL Ensure™) samples (0-120 min) were collected (pre-VSG [V1], 1 [V2], and 3 months [V3] post-VSG) for analysis of BA, FGF19, and FGF21.



Post-VSG subjects lost weight (V2 11.8 ± 0.8 kg; V3 21.9 ± 1.7 kg). BA and FGF19 increased by V2, 143.6% at 30 min and 74.9% at 90 min post-meal, respectively. BA hydrophobicity index also improved by V3, 21.1% at 30 min post-meal. Interestingly, fasting and 120-min post-meal FGF21 levels at V2 were increased by 135.7% and 253.9%, respectively, but then returned to baseline at V3. BA levels correlated with FGF21 at V2 (P = 0.003, r = 0.89), and body weight lost post-VSG correlated with FGF21 levels (V2; P = 0.012, R = 0.82).



Expected changes were seen in BA and FGF19 biology after VSG in adolescents, but novel changes were seen in correlation between the early postsurgical increase in FGF21 and weight loss, suggesting that FGF21 may play a role in energy balance postoperatively, and further investigation is warranted.
Division of General Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Farooq H
FH
Khan
Department of Pediatric Surgery, Surgical Weight Loss Program for Teens, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Lindsey
L
Shaw
Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Wujuan
W
Zhang
Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Rosa Maria
RM
Salazar Gonzalez
Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Sarah
S
Mowery
Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Melissa
M
Oehrle
Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Xueheng
X
Zhao
Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Todd
T
Jenkins
Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Kenneth D R
KD
Setchell
Department of Pediatric Surgery, Surgical Weight Loss Program for Teens, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Thomas H
TH
Inge
Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, California, USA. rokohli@chla.usc.edu.
Rohit
R
Kohli
D000293:Adolescent; D001647:Bile Acids and Salts / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D004734:Energy Metabolism; D005215:Fasting / Q000502:physiology; D005260:Female; D005346:Fibroblast Growth Factors / Q000502:physiology*; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D015431:Weight Loss / Q000502:physiology*
D001647:Bile Acids and Salts; C117476:FGF19 protein, human; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors