Acute post-bariatric surgery increase in orexin levels associates with preferential lipid profile improvement.

Abstract

CONTEXT:

Orexin is a recently identified neuropeptide hormone.

OBJECTIVES:

Acute and long-term post-bariatric changes in Orexin and relationship to post-operative metabolic outcomes.

DESIGN AND PARTICIPANTS:

Men and women undergoing biliopancreatic diversion with duodenal switch bariatric surgery (n = 76, BMI≥35 kg/m(2)) were evaluated for body composition and plasma parameters at baseline, acutely (1 and 5 days) and long-term (6 and 12 months) post-surgery.

SETTING:

University Hospital Centre, Canada.

INTERVENTIONS AND MAIN OUTCOME MEASURES:

Groups were subdivided based on acute (average 1 and 5 day) changes in Orexin prior to weight loss: (i)>10% Orexin decrease (n = 33, OrexinDEC) and (ii)>10% Orexin increase (n = 20, OrexinINC), to evaluate impact on long-term changes.

RESULTS:

Both groups had comparable preoperative Orexin levels, BMI, age, sex distribution, diabetes and lipid lowering medication, plasma glucose and lipid parameters except for apolipoproteinB (p<0.007). Orexin increase was rapid and maintained throughout one year, while OrexinDEC subjects remained significantly lower throughout. Over 12 months, changes in BMI, fat mass, and %fat mass were comparable. Fasting glucose and insulin increased immediately 1-day post-operatively, decreasing rapidly (5-day) and declining thereafter with the OrexinINC group remaining lower than the OrexinDEC group throughout (p = 0.001). Similarly, plasma cholesterol, triglyceride, LDL-C and HDL-C decreased at 1-day, increased slightly (5-day), except HDL-C, then decreased over 1 year, with greater decreases in OrexinINC group relative to OrexinDEC group.

CONCLUSION:

Rapid postoperative increases in plasma Orexin are associated with better improvement of glucose and lipid profiles following bariatric surgery.

• Authors: Abhishek Gupta, Pierre Miegueu, Marc Lapointe, Paul Poirier, Julie Martin, Marjorie Bastien, Sunita Tiwari, Katherine Cianflone
• Journal: PloS one (PLoS One) Vol. 9 Issue 1 Pg. e84803 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24400115 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Apolipoproteins B
• Blood Glucose
• Intracellular Signaling Peptides and Proteins
• Lipids
• Neuropeptides
• Orexins
• C-Reactive Protein

Topics

• Adult
• Apolipoproteins B (blood)
• Bariatric Surgery
• Blood Glucose
• Body Composition
• Body Mass Index
• C-Reactive Protein
• Female
• Humans
• Intracellular Signaling Peptides and Proteins (blood)
• Lipid Metabolism
• Lipids (blood)
• Male
• Middle Aged
• Neuropeptides (blood)
• Orexins
• Postoperative Period
• Risk Factors
• Time Factors