pp 1–8 | Cite as

Serum IGF-binding protein 2 (IGFBP-2) concentrations change early after gastric bypass bariatric surgery revealing a possible marker of leptin sensitivity in obese subjects

  • Giovanni CeccariniEmail author
  • Caterina Pelosini
  • Federica Ferrari
  • Silvia Magno
  • Jacopo Vitti
  • Guido Salvetti
  • Carlo Moretto
  • Antonio Marioni
  • Piero Buccianti
  • Paolo Piaggi
  • Margherita Maffei
  • Ferruccio Santini
Original Article



Expression of IGFBP-2 in mice is regulated by leptin. Over-expression of IGFBP-2 is associated with reduced caloric intake and resistance to weight gain. Hormonal variations contributing to weight loss occur very early after bariatric surgery but have not been fully elucidated. We evaluated IGFBP-2 serum changes after bariatric surgery and their relationship with leptin variations to test the hypothesis that an increase of leptin sensitivity may explain some of the effects of gastric bypass.


This is a historical prospective study. Fifty-one obese patients (41 women e 10 men), 9 non-obese surgical controls and 41 lean matched controls were studied. Serum IGFBP-2 and leptin were measured after bariatric bypass surgery at various time points up to 18 months, after non-bariatric laparoscopic surgery in a control group, and in lean matched controls.


Compared to lean controls, serum IGFBP-2 levels were lower in obese patients. After gastric bypass, IGFBP-2 significantly increased at 3 days and became normal before the occurrence of relevant changes in body weight, remaining stable up to 18 months after surgery. IGFBP-2/leptin ratio increased early after surgery and became normal after one year.


After gastric bypass, serum IGFBP-2 increases in a window of time when variations of hormones mediating the effects of bariatric surgery occur. Our results suggest that IGFBP-2, a leptin-regulated protein, may be an in-vivo marker of leptin action. If this is the case, an early improvement of leptin sensitivity might contribute to the anorectic effect of gastric bypass.


IGFBP-2 Bariatric surgery Gastric bypass Obesity Leptin sensitivity 



We thank Lucia Nardelli, Martina Passetto and Massimiliano Benvenuti for their help in managing patients’ samples.


This work was supported by the Rita Levi Montalcini program funding (year 2009). The study was partially supported by the Italian Ministry of the University, Project code 2015JSWLTN: Metabolic flexibility and ectopic fat. Adiposity phenotype, mitochondrial dysfunction, hepatic inflammation, gut microbiota, cardiac failure and genetics for a comprehensive understanding of the cross-talk among adipose tissue, liver, and musculo-skeletal system.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest related to this study.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Local Ethical Committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individuals included in this study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Giovanni Ceccarini
    • 1
    Email author
  • Caterina Pelosini
    • 1
  • Federica Ferrari
    • 1
  • Silvia Magno
    • 1
  • Jacopo Vitti
    • 1
  • Guido Salvetti
    • 1
  • Carlo Moretto
    • 2
  • Antonio Marioni
    • 3
  • Piero Buccianti
    • 3
  • Paolo Piaggi
    • 1
    • 4
  • Margherita Maffei
    • 1
    • 5
  • Ferruccio Santini
    • 1
  1. 1.Obesity Center, Endocrinology UnitUniversity Hospital of PisaPisaItaly
  2. 2.Unit of Bariatric SurgeryUniversity Hospital of PisaPisaItaly
  3. 3.Unit of SurgeryUniversity Hospital of PisaPisaItaly
  4. 4.National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthPhoenixUnited States
  5. 5.Institute of Clinical PhysiologyItalian National Research CouncilPisaItaly

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