Identification of Proteins Associated with the Early Restoration of Insulin Sensitivity After Biliopancreatic Diversion

Marco Raffaelli, Geltrude Mingrone, Amerigo Iaconelli, Cecilia Karlsson, Kristina Wallenius, Anna Walentinsson, Peter J. Greasley, Tasso Miliotis, Mårten Hammar, Sofia Tapani, Björn Carlsson

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

CONTEXT: Insulin resistance (IR) is a risk factor for type 2 diabetes, diabetic kidney disease, cardiovascular disease and nonalcoholic steatohepatitis. Biliopancreatic diversion (BPD) is the most effective form of bariatric surgery for improving insulin sensitivity. OBJECTIVE: To identify plasma proteins correlating with the early restoration of insulin sensitivity after BPD. DESIGN: Prospective single-center study including 20 insulin-resistant men with morbid obesity scheduled for BPD. Patient characteristics and blood samples were repeatedly collected from baseline up to 4 weeks postsurgery. IR was assessed by homeostatic model assessment for insulin resistance (HOMA-IR), Matsuda Index, and by studying metabolic profiles during meal tolerance tests. Unbiased proteomic analysis was performed to identify plasma proteins altered by BPD. Detailed plasma profiles were made on a selected set of proteins by targeted multiple reaction monitoring mass spectrometry (MRM/MS). Changes in plasma proteome were evaluated in relation to metabolic and inflammatory changes. RESULTS: BPD resulted in improved insulin sensitivity and reduced body weight. Proteomic analysis identified 29 proteins that changed following BPD. Changes in plasma levels of afamin, apolipoprotein A-IV (ApoA4), and apolipoprotein A-II (ApoA2) correlated significantly with changes in IR. CONCLUSION: Circulating levels of afamin, ApoA4, and ApoA2 were associated with and may contribute to the rapid improvement in insulin sensitivity after BPD.
Lingua originaleEnglish
pagine (da-a)4157-4168.
Numero di pagine11
RivistaTHE JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume105
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • afamin
  • apolipoprotein A-II
  • apolipoprotein A-IV
  • biliopancreatic diversion
  • insulin resistance
  • proteomic analysis

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