Unité d'endocrinologie-Diabétologie-Nutrition, CHRU de Tours, 37044, Tours, France.
INSERM UMR 1069, Nutrition, Croissance Et Cancer, 37000, Tours, France.
Obes Surg. 2023 Aug;33(8):2468-2474. doi: 10.1007/s11695-023-06702-3. Epub 2023 Jun 30.
The association between bariatric surgery outcome and blood levels of fibroblast growth factor 21 (FGF21) remains controversial. Many patients displayed stable or decreased FGF21 one year after bariatric surgery. Nevertheless, there is often an early increase FGF21 concentration in the post-surgery period. The aim of this study was to investigate the relationship between 3-month FGF21 response and percentage total weight loss at one year after bariatric surgery.
In this prospective monocentric study, a total of 144 patients with obesity grade 2-3 were included; 61% of them underwent a sleeve gastrectomy and 39% a Roux-en-Y gastric bypass. Data analysis was carried out to determine the relation between 3-month plasma FGF21 response and weight loss one year after bariatric surgery. Multiple adjustments were done including degree of weight loss after 3 months.
FGF21 significantly increased between baseline and Month 3 (n = 144, p < 10), then decreased between Month 3 and Month 6 (n = 142, p = 0.047) and was not different from baseline at Month 12 (n = 142, p = 0.86). The 3-month-FGF21 response adjusted to body weight loss was not different between types of bariatric surgery. The 3-month-FGF21 response was associated to body weight loss at Month 6 (r = -0.19, p = 0.02) and Month 12 (r = -0.34, p < 10). After multiple regression analysis, only Month 12 body weight loss remained associated to 3-month FGF21 response (r = -0.3, p = 0.02).
This study showed that the magnitude of changes in FGF21 at 3 months after bariatric surgery emerged as an independent predictor of one-year body weight loss irrespective of the type of surgery.
肥胖症患者接受减重手术后，成纤维细胞生长因子 21（FGF21）的血液水平与手术结果之间的关联仍存在争议。许多患者在接受减重手术后一年时 FGF21 水平稳定或降低。然而，手术后的早期 FGF21 浓度通常会升高。本研究旨在探讨 3 个月时 FGF21 的反应与减重手术后一年总体重减轻百分比之间的关系。
在这项前瞻性单中心研究中，共纳入 144 名肥胖症 2-3 级患者；其中 61%接受了袖状胃切除术，39%接受了 Roux-en-Y 胃旁路术。进行数据分析以确定 3 个月时血浆 FGF21 反应与减重手术后一年的体重减轻之间的关系。进行了多项调整，包括 3 个月后体重减轻的程度。
FGF21 在基线和第 3 个月之间显著增加（n=144，p<0.001），然后在第 3 个月和第 6 个月之间降低（n=142，p=0.047），在第 12 个月时与基线无差异（n=142，p=0.86）。调整至体重减轻的 3 个月 FGF21 反应在两种减重手术类型之间无差异。3 个月 FGF21 反应与第 6 个月（r=-0.19，p=0.02）和第 12 个月（r=-0.34，p<0.001）的体重减轻相关。多元回归分析后，仅第 12 个月体重减轻与 3 个月 FGF21 反应相关（r=-0.3，p=0.02）。
本研究表明，减重手术后 3 个月时 FGF21 的变化幅度是一年后体重减轻的独立预测因素，与手术类型无关。
