Identification of Proteins Associated with the Early Restoration of Insulin Sensitivity After Biliopancreatic Diversion.

Abstract

CONTEXT:

Insulin resistance (IR) is a risk factor for type 2 diabetes, diabetic kidney disease, cardiovascular disease and nonalcoholic steatohepatitis. Biliopancreatic diversion (BPD) is the most effective form of bariatric surgery for improving insulin sensitivity.

OBJECTIVE:

To identify plasma proteins correlating with the early restoration of insulin sensitivity after BPD.

DESIGN:

Prospective single-center study including 20 insulin-resistant men with morbid obesity scheduled for BPD. Patient characteristics and blood samples were repeatedly collected from baseline up to 4 weeks postsurgery. IR was assessed by homeostatic model assessment for insulin resistance (HOMA-IR), Matsuda Index, and by studying metabolic profiles during meal tolerance tests. Unbiased proteomic analysis was performed to identify plasma proteins altered by BPD. Detailed plasma profiles were made on a selected set of proteins by targeted multiple reaction monitoring mass spectrometry (MRM/MS). Changes in plasma proteome were evaluated in relation to metabolic and inflammatory changes.

RESULTS:

BPD resulted in improved insulin sensitivity and reduced body weight. Proteomic analysis identified 29 proteins that changed following BPD. Changes in plasma levels of afamin, apolipoprotein A-IV (ApoA4), and apolipoprotein A-II (ApoA2) correlated significantly with changes in IR.

CONCLUSION:

Circulating levels of afamin, ApoA4, and ApoA2 were associated with and may contribute to the rapid improvement in insulin sensitivity after BPD.

• Authors: Cecilia Karlsson, Kristina Wallenius, Anna Walentinsson, Peter J Greasley, Tasso Miliotis, Mårten Hammar, Amerigo Iaconelli, Sofia Tapani, Marco Raffaelli, Geltrude Mingrone, Björn Carlsson
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 105 Issue 11 (11 01 2020) ISSN: 1945-7197 [Electronic] United States
• PMID: 32830851 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Endocrine Society 2020.

Chemical References

• Blood Glucose

Topics

• Adult
• Biliopancreatic Diversion
• Blood Glucose (metabolism)
• Body Mass Index
• Glucose Tolerance Test
• Humans
• Insulin Resistance (physiology)
• Male
• Middle Aged
• Obesity, Morbid (blood, surgery)
• Proteomics