Calorie restriction and Roux-en-Y gastric bypass have opposing effects on circulating FGF21 in morbidly obese subjects

M.A. Lips; G.H. de Groot; F.J. Berends; R. Wiezer; B.A. van Wagensveld; D. J. Swank; A. Luijten; K.W. van Dijk; H. Pijl; P.L.M. Jansen; F.G. Schaap

doi:10.1111/cen.12496

Calorie restriction and Roux-en-Y gastric bypass have opposing effects on circulating FGF21 in morbidly obese subjects

M.A. Lips^*, G.H. de Groot, F.J. Berends, R. Wiezer, B.A. van Wagensveld, D. J. Swank, A. Luijten, K.W. van Dijk, H. Pijl, P.L.M. Jansen, F.G. Schaap

^*Corresponding author for this work

Surgery

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To study the effect of different weight loss strategies on levels of the metabolic regulator FGF21 in morbidly obese females with normal glucose tolerance (NGT) or type 2 diabetes mellitus (T2DM). DESIGN: Observational intervention trial. PATIENTS AND MEASUREMENTS: Weight reduction was achieved by Gastric Banding (GB, n = 11) or Roux-en-Y Gastric Bypass (RYGB, n = 16) in subjects with NGT, and by RYGB (n = 15) or a very-low-calorie diet (VLCD, n = 12) in type 2 diabetics. Fasted and/or postprandial levels of FGF21, FGF19 (an FGF21-related postprandial hormone) and bile salts (implicated in regulation of FGF21 and FGF19 expression) were measured before, and 3 and 12 weeks after intervention. RESULTS: Fasted FGF21 levels were elevated in T2DM subjects. Calorie restriction by either GB or VLCD lowered bile salt and FGF21 levels. In contrast, RYGB surgery was associated with elevated bile salt and FGF21 levels. CONCLUSIONS: Calorie restriction and RYGB have opposite effects on serum bile salt and FGF21 levels. Calorie restriction results in FGF21 approaching nonobese control levels, suggesting that this intervention is effective in reducing the "nutritional crisis" that appears to underly FGF21 elevation in obesity. FGF21 elevation after RYGB may contribute to the beneficial effect of this procedure.

Original language	English
Journal	Clinical Endocrinology
DOIs	https://doi.org/10.1111/cen.12496
Publication status	Published - 1 Jan 2014

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10.1111/cen.12496

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@article{35171d7196ec47b3a01334e76d202e54,

title = "Calorie restriction and Roux-en-Y gastric bypass have opposing effects on circulating FGF21 in morbidly obese subjects",

abstract = "OBJECTIVE: To study the effect of different weight loss strategies on levels of the metabolic regulator FGF21 in morbidly obese females with normal glucose tolerance (NGT) or type 2 diabetes mellitus (T2DM). DESIGN: Observational intervention trial. PATIENTS AND MEASUREMENTS: Weight reduction was achieved by Gastric Banding (GB, n = 11) or Roux-en-Y Gastric Bypass (RYGB, n = 16) in subjects with NGT, and by RYGB (n = 15) or a very-low-calorie diet (VLCD, n = 12) in type 2 diabetics. Fasted and/or postprandial levels of FGF21, FGF19 (an FGF21-related postprandial hormone) and bile salts (implicated in regulation of FGF21 and FGF19 expression) were measured before, and 3 and 12 weeks after intervention. RESULTS: Fasted FGF21 levels were elevated in T2DM subjects. Calorie restriction by either GB or VLCD lowered bile salt and FGF21 levels. In contrast, RYGB surgery was associated with elevated bile salt and FGF21 levels. CONCLUSIONS: Calorie restriction and RYGB have opposite effects on serum bile salt and FGF21 levels. Calorie restriction results in FGF21 approaching nonobese control levels, suggesting that this intervention is effective in reducing the {"}nutritional crisis{"} that appears to underly FGF21 elevation in obesity. FGF21 elevation after RYGB may contribute to the beneficial effect of this procedure.",

author = "M.A. Lips and {de Groot}, G.H. and F.J. Berends and R. Wiezer and {van Wagensveld}, B.A. and Swank, {D. J.} and A. Luijten and {van Dijk}, K.W. and H. Pijl and P.L.M. Jansen and F.G. Schaap",

year = "2014",

month = jan,

day = "1",

doi = "10.1111/cen.12496",

language = "English",

journal = "Clinical Endocrinology",

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TY - JOUR

T1 - Calorie restriction and Roux-en-Y gastric bypass have opposing effects on circulating FGF21 in morbidly obese subjects

AU - Lips, M.A.

AU - de Groot, G.H.

AU - Berends, F.J.

AU - Wiezer, R.

AU - van Wagensveld, B.A.

AU - Swank, D. J.

AU - Luijten, A.

AU - van Dijk, K.W.

AU - Pijl, H.

AU - Jansen, P.L.M.

AU - Schaap, F.G.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - OBJECTIVE: To study the effect of different weight loss strategies on levels of the metabolic regulator FGF21 in morbidly obese females with normal glucose tolerance (NGT) or type 2 diabetes mellitus (T2DM). DESIGN: Observational intervention trial. PATIENTS AND MEASUREMENTS: Weight reduction was achieved by Gastric Banding (GB, n = 11) or Roux-en-Y Gastric Bypass (RYGB, n = 16) in subjects with NGT, and by RYGB (n = 15) or a very-low-calorie diet (VLCD, n = 12) in type 2 diabetics. Fasted and/or postprandial levels of FGF21, FGF19 (an FGF21-related postprandial hormone) and bile salts (implicated in regulation of FGF21 and FGF19 expression) were measured before, and 3 and 12 weeks after intervention. RESULTS: Fasted FGF21 levels were elevated in T2DM subjects. Calorie restriction by either GB or VLCD lowered bile salt and FGF21 levels. In contrast, RYGB surgery was associated with elevated bile salt and FGF21 levels. CONCLUSIONS: Calorie restriction and RYGB have opposite effects on serum bile salt and FGF21 levels. Calorie restriction results in FGF21 approaching nonobese control levels, suggesting that this intervention is effective in reducing the "nutritional crisis" that appears to underly FGF21 elevation in obesity. FGF21 elevation after RYGB may contribute to the beneficial effect of this procedure.

AB - OBJECTIVE: To study the effect of different weight loss strategies on levels of the metabolic regulator FGF21 in morbidly obese females with normal glucose tolerance (NGT) or type 2 diabetes mellitus (T2DM). DESIGN: Observational intervention trial. PATIENTS AND MEASUREMENTS: Weight reduction was achieved by Gastric Banding (GB, n = 11) or Roux-en-Y Gastric Bypass (RYGB, n = 16) in subjects with NGT, and by RYGB (n = 15) or a very-low-calorie diet (VLCD, n = 12) in type 2 diabetics. Fasted and/or postprandial levels of FGF21, FGF19 (an FGF21-related postprandial hormone) and bile salts (implicated in regulation of FGF21 and FGF19 expression) were measured before, and 3 and 12 weeks after intervention. RESULTS: Fasted FGF21 levels were elevated in T2DM subjects. Calorie restriction by either GB or VLCD lowered bile salt and FGF21 levels. In contrast, RYGB surgery was associated with elevated bile salt and FGF21 levels. CONCLUSIONS: Calorie restriction and RYGB have opposite effects on serum bile salt and FGF21 levels. Calorie restriction results in FGF21 approaching nonobese control levels, suggesting that this intervention is effective in reducing the "nutritional crisis" that appears to underly FGF21 elevation in obesity. FGF21 elevation after RYGB may contribute to the beneficial effect of this procedure.

U2 - 10.1111/cen.12496

DO - 10.1111/cen.12496

M3 - Article

SN - 0300-0664

JO - Clinical Endocrinology

JF - Clinical Endocrinology

ER -