Di Vincenzo Angelo, Granzotto Marnie, Trevellin Elisabetta, Capone Federico, Prevedello Luca, Foletto Mirto, Vettor Roberto, Rossato Marco
Internal Medicine III, Department of Medicine, University Hospital of Padova, Padua, Italy.
Endocrine-Metabolic Laboratory, Department of Medicine, University Hospital of Padova, Padua, Italy.
Obes Surg. 2025 Jan;35(1):341-344. doi: 10.1007/s11695-024-07625-3. Epub 2024 Dec 11.
The mechanisms by which bariatric/metabolic surgery induces weight loss and the amelioration of obesity-associated complications are far from being fully elucidated. Variations in circulating hormones involved in the regulation of energy balance are usually considered to explain the effects of surgery beyond the restrictive mechanism. Recent studies have shown that gastric bypass modulates the plasma levels of GDF15, a molecule with anorectic action potentially contributing to the body weight reduction observed after surgery. Here, we report that sleeve gastrectomy has different effects on GDF15 plasma levels in patients with obesity depending on the presence of metabolic syndrome (MetS). Patients with MetS showed higher GDF15 plasma levels at baseline, but they had no increase in hormone concentrations compared to patients without MetS. Furthermore, at baseline, a correlation between blood glucose and GDF15 was observed in patients with MetS, and between plasma insulin and GDF15 in patients without MetS. Considering this data, GDF15 seems a molecule reflecting the severity of metabolic derangements not directly involved in mechanisms of surgical weight loss, and its role in obesity physiopathology and treatment needs to be further investigated.
减重/代谢手术导致体重减轻以及改善肥胖相关并发症的机制尚未完全阐明。参与能量平衡调节的循环激素变化通常被认为可以解释手术除限制机制之外的其他作用。最近的研究表明，胃旁路手术可调节生长分化因子15（GDF15）的血浆水平，GDF15是一种具有厌食作用的分子，可能有助于解释手术后观察到的体重减轻。在此，我们报告，根据代谢综合征（MetS）的存在情况，袖状胃切除术对肥胖患者的GDF15血浆水平有不同影响。患有MetS的患者在基线时GDF15血浆水平较高，但与未患MetS的患者相比，其激素浓度没有增加。此外，在基线时，患有MetS的患者血糖与GDF15之间存在相关性，而未患MetS的患者血浆胰岛素与GDF15之间存在相关性。考虑到这些数据，GDF15似乎是一个反映代谢紊乱严重程度的分子，并不直接参与手术减重机制，其在肥胖病理生理学和治疗中的作用需要进一步研究。
