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    Impact of gut hormone FGF-19 on type-2 diabetes and mitochondrial recovery in a prospective study of obese diabetic women undergoing bariatric surgery.

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    Authors
    de la Escalera, L.M
    Kyrou, I
    Vrbikova, J
    Hainer, V
    Sramkova, P
    Fried, M
    Piya, M.K
    Kumar, S
    Tripathi, G
    McTernan, P.G
    Affiliation
    University of Warwick
    Issue Date
    16/02/2017
    
    Metadata
    Show full item record
    Abstract
    The ileal-derived hormone, fibroblast growth factor 19 (FGF-19), may promote weight loss and facilitate type-2 diabetes mellitus remission in bariatric surgical patients. We investigated the effect of different bariatric procedures on circulating FGF-19 levels and the resulting impact on mitochondrial health in white adipose tissue (AT). Obese and type-2 diabetic women (n = 39, BMI > 35 kg/m2) undergoing either biliopancreatic diversion (BPD), laparoscopic greater curvature plication (LGCP), or laparoscopic adjustable gastric banding (LAGB) participated in this ethics approved study. Anthropometry, biochemical, clinical data, serum, and AT biopsies were collected before and 6 months after surgery. Mitochondrial gene expression in adipose biopsies and serum FGF-19 levels were then assessed. All surgeries led to metabolic improvements with BPD producing the greatest benefits on weight loss (↓30%), HbA1c (↓28%), and cholesterol (↓25%) reduction, whilst LGCP resulted in similar HbA1c improvements (adjusted for BMI). Circulating FGF-19 increased in both BPD and LGCP (χ2(2) = 8.088; P = 0.018), whilst, in LAGB, FGF-19 serum levels decreased (P = 0.028). Interestingly, circulating FGF-19 was inversely correlated with mitochondrial number in AT across all surgeries (n = 39). In contrast to LGCP and LAGB, mitochondrial number in BPD patients corresponded directly with changes in 12 of 14 mitochondrial genes assayed (P < 0.01). Elevated serum FGF-19 levels post-surgery were associated with improved mitochondrial health in AT and overall diabetic remission. Changes in circulating FGF-19 levels were surgery-specific, with BPD producing the best metabolic outcomes among the study procedures (BPD > LGCP > LAGB), and highlighting mitochondria in AT as a potential target of FGF-19 during diabetes remission.
    Citation
    de la Escalera, L.M., Kyrou, I., Vrbikova, J., et al. (2017). 'Impact of gut hormone FGF-19 on type-2 diabetes and mitochondrial recovery in a prospective study of obese diabetic women undergoing bariatric surgery'. BMC medicine, 15(1), pp, 1-9. DOI: 10.1186/s12916-017-0797-5
    Publisher
    BMC
    Journal
    BMC Medicine
    URI
    http://hdl.handle.net/10545/624100
    DOI
    10.1186/s12916-017-0797-5
    Additional Links
    https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0797-5
    Type
    Article
    Language
    en
    EISSN
    17417015
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12916-017-0797-5
    Scopus Count
    Collections
    School of Human Sciences

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