Nielsen Mette S, Søberg Susanna, Schmidt Julie B, Chenchar Anne, Sjödin Anders, Gillum Matthew P
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
PeerJ. 2021 Apr 14;9:e11174. doi: 10.7717/peerj.11174. eCollection 2021.
Despite a consistent link between obesity and increased circulating levels of fibroblast growth factor-21 (FGF21), the effect of weight-loss interventions on FGF21 is not clear. We aimed to determine the short- and long-term effects of Roux-en-Y gastric bypass (RYGB) on intact plasma FGF21 levels and to test the hypothesis that RYGB, but not diet-induced weight loss, increases fasting and postprandial responses of FGF21.
Twenty-eight participants with obesity followed a low-calorie diet for 11 weeks. The 28 participants were randomized to undergo RYGB surgery at week 8 (RYGB group, = 14), or to a control group scheduled for surgery at week 12 ( = 14). Fasting levels of intact, biologically active FGF21 (amino acids 1-181) and its postprandial responses to a mixed meal were assessed at week 7 and 11, and 78 weeks (18 months) after RYGB.
At week 11 (3 weeks after RYGB), postprandial responses of intact FGF21 were enhanced in participants undergoing surgery at week 8 (change from week 7 to 11: = 0.02), whereas no change was found in non-operated control participants in similar negative energy balance (change from week 7 to 11: = 0.81). However, no between-group difference was found ( = 0.27 for the group-week-time interaction). Fasting, as well as postprandial responses in intact FGF21, were unchanged 18 months after RYGB when both the RYGB and control group were collapsed together (change from week 7 to 78 weeks after RYGB: = 0.17).
Postprandial intact FGF21 levels were enhanced acutely after RYGB whereas no signs of sustained changes were found 18 months after surgery. When comparing the acute effect of RYGB with controls in similar negative energy balance, we failed to detect any significant differences between groups, probably due to the small sample size and large inter-individual variations, especially in response to surgery.
尽管肥胖与循环中成纤维细胞生长因子21（FGF21）水平升高之间存在持续关联，但减肥干预对FGF21的影响尚不清楚。我们旨在确定Roux-en-Y胃旁路术（RYGB）对完整血浆FGF21水平的短期和长期影响，并检验以下假设：RYGB而非饮食诱导的体重减轻会增加FGF21的空腹和餐后反应。
28名肥胖参与者遵循低热量饮食11周。这28名参与者被随机分为在第8周接受RYGB手术（RYGB组，n = 14），或分为在第12周安排手术的对照组（n = 14）。在第7周、第11周以及RYGB术后78周（18个月）评估完整的、具有生物活性的FGF21（氨基酸1 - 181）的空腹水平及其对混合餐的餐后反应。
在第11周（RYGB术后3周），第8周接受手术的参与者中完整FGF21的餐后反应增强（从第7周到第11周的变化：P = 0.02），而处于类似负能量平衡状态的未手术对照组参与者未发现变化（从第7周到第11周的变化：P = 0.81）。然而，未发现组间差异（组 - 周 - 时间交互作用的P = 0.27）。当将RYGB组和对照组合并在一起时，RYGB术后18个月，完整FGF21的空腹以及餐后反应均未改变（从第7周到RYGB术后78周的变化：P = 0.17）。
RYGB术后即刻餐后完整FGF21水平升高，而术后18个月未发现持续变化的迹象。在比较处于类似负能量平衡状态的RYGB与对照组的急性效应时，我们未能检测到组间有任何显著差异，这可能是由于样本量小以及个体间差异大，尤其是对手术的反应差异大所致。
