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

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) 2019;42(12):2057-2061

PMID: 29795470

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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.

Address: Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany. [email protected].; Department of Anaesthesiology and Intensive Care, Jena University Hospital, Jena, Germany. [email protected].; Department of Surgery, Sapienza University of Rome, Rome, Italy.; Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany.; Sphingotec GmbH, Hennigsdorf, Germany.; Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany.; Study Center for Metabolic Vascular Medicine, GWT-TU Dresden GmbH, Dresden, Germany.; Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany.; Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy.; Diabetes and Nutritional Sciences, King's College London, London, UK.; Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany.; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.; Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy.; Diabetes and Nutritional Sciences, King's College London, London, UK.; Section of Metabolic and Vascular Medicine, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany. [email protected].; Study Center for Metabolic Vascular Medicine, GWT-TU Dresden GmbH, Dresden, Germany. [email protected].; Diabetes and Nutritional Sciences, King's College London, London, UK. [email protected].; Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany. [email protected].; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany. [email protected].

DOI: 10.1038/s41366-018-0084-3

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MeSH Terms: Adult, Biliopancreatic Diversion, Blood Glucose, Female, Gastric Bypass, Humans, Insulin Resistance, Male, Middle Aged, Neurotensin, Obesity, Morbid, Protein Precursors