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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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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

Funding

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.

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Authors and Affiliations

  1. Obesity Center, Endocrinology Unit, University Hospital of Pisa, Pisa, Italy

    Giovanni Ceccarini, Caterina Pelosini, Federica Ferrari, Silvia Magno, Jacopo Vitti, Guido Salvetti, Paolo Piaggi, Margherita Maffei & Ferruccio Santini

  2. Unit of Bariatric Surgery, University Hospital of Pisa, Pisa, Italy

    Carlo Moretto

  3. Unit of Surgery, University Hospital of Pisa, Pisa, Italy

    Antonio Marioni & Piero Buccianti

  4. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, United States

    Paolo Piaggi

  5. Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy

    Margherita Maffei

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  1. Giovanni Ceccarini
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  2. Caterina Pelosini
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  3. Federica Ferrari
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Correspondence to Giovanni Ceccarini.

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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.

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Ceccarini, G., Pelosini, C., Ferrari, F. et al. 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. Endocrine 65, 86–93 (2019). https://doi.org/10.1007/s12020-019-01915-y

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