Martinez de la Escalera Clapp, Lucia, Kyrou, Ioannis, Vrbikova, Jana, Hainer, Voitech, Sramkova, Petra, Fried, Martin, Piya, Milan K., Kumar, Sudhesh, Tripathi, Gyanendra and McTernan, P. G. (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). 34. doi:10.1186/s12916-017-0797-5

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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.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Biomedical Sciences Faculty of Medicine > Warwick Medical School > Dean's Office & Professional Support Services Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Medicine > Warwick Medical School
SWORD Depositor:	Library Publications Router
Library of Congress Subject Headings (LCSH):	Non-insulin-dependent diabetes., Gastrointestinal hormones., Obesity—Surgery., Fibroblast growth factors., Obesity., Mitochondria.
Journal or Publication Title:	BMC Medicine
Publisher:	BioMed Central Ltd.
ISSN:	1741-7015
Official Date:	16 February 2017
Dates:	Date Event 16 February 2017 Published 18 January 2017 Accepted
Date of first compliant deposit:	19 September 2017
Volume:	15
Number:	1
Article Number:	34
DOI:	10.1186/s12916-017-0797-5
Status:	Peer Reviewed
Publication Status:	Published
Publisher Statement:	** From Europe PMC via Jisc Publications Router. ** Licence for this article: cc by
Access rights to Published version:	Open Access
Funder:	European Foundation for the Study of Diabetes (EFSD), Consejo Nacional de Ciencia y Tecnología (CONACYT), National Institute for Health Research (Great Britain) (NIHR)

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