The anorexigenic peptide neurotensin relates to insulin sensitivity in obese patients after BPD or RYGB metabolic surgery.

Abstract

Neurotensin is a peptide with effects on appetite and intestinal lipid absorption. Experimental data suggest a role in glucose homeostasis, while human data is missing. Here, 20 morbidly obese subjects either underwent biliopancreatic diversion with duodenal switch (BPD), or Roux-en-Y gastric bypass (RYGB) in a randomized fashion. Before and 1 year after surgery, anthropometric data, body composition, clinical biochemistry, insulin sensitivity by means of euglycemic hyperinsulinemic clamps (HEC) and fasting plasma proneurotensin 1-117 were analyzed. Plasma proneurotensin increased significantly more 1 year after BDP than RYGB (P = 0.028), while weight loss was comparable. After metabolic surgery, proneurotensin correlated positively with insulin sensitivity (M-value) (r = 0.55, P < 0.001), while an inverse relationship with fasting glucose, HOMA-IR and HbA1c was observed (P < 0.05 for all components). After adjustment for age and gender, proneurotensin and BMI remained independently related with delta of M-value (β = 0.46 and β = 0.51, P < 0.05, resp.). From these data we conclude that proneurotensin positively correlates with insulin sensitivity uniquely after weight loss induced by metabolic surgery in humans. BDP leads to a stronger increase in the anorexigenic peptide compared to RYGB.

• Authors: Christian von Loeffelholz, Lidia Castagneto Gissey, Tina Schumann, Christine Henke, Anica Kurzbach, Joachim Struck, Andreas Bergmann, Markolf Hanefeld, Ulrike Schatz, Stefan R Bornstein, Giovanni Casella, Geltrude Mingrone, Andreas L Birkenfeld
• Journal: International journal of obesity (2005) (Int J Obes (Lond)) Vol. 42 Issue 12 Pg. 2057-2061 (12 2018) ISSN: 1476-5497 [Electronic] England
• PMID: 29795470 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Protein Precursors
• proneurotensin
• Neurotensin

Topics

• Adult
• Biliopancreatic Diversion (statistics & numerical data)
• Blood Glucose (analysis, metabolism)
• Female
• Gastric Bypass (statistics & numerical data)
• Humans
• Insulin Resistance (physiology)
• Male
• Middle Aged
• Neurotensin (blood)
• Obesity, Morbid (blood, epidemiology, metabolism, surgery)
• Protein Precursors (blood)