Background: Bariatric surgery is an effective treatment for severe obesity. It also ameliorates diabetes independently of weight loss through mechanisms that are not fully understood. In this study, we investigated the levels of GH, IGF-1 and IGF-binding protein 2 (IGFBP-2) after gastric sleeve surgery in healthy obese individuals. Method: This study was conducted in 33 obese (BMI > 38.3) healthy male subjects aged 25 to 50 years undergoing sleeve gastrectomy. GH, IGF-1 and IGFBP-2 levels were evaluated by ELISA at baseline and 6-12 months after surgery. Other parameters, such as glucose, BMI, insulin, HOMA-IR and lipid profile, were also investigated. Results: Systemic GH (12.32 vs. 50.97 pg/mL, p < 0.001) and IGFBP-2 levels (51.86 vs. 68.81 pg/mL, p < 0.001) were elevated after bariatric surgery. There was no change in IGF-1 level from before to after surgery. BMI (52.18 vs. 40.11, p = 0.001), insulin (19.35 vs. 8.80 mIU/L, p < 0.001) and HOMA-IR index (6.48 to 2.52, p < 0.001) were reduced after surgery. Lipid profile analysis revealed that total cholesterol (4.26 vs. 5.12 mmol/L, p < 0.001) and high-density lipoprotein (HDL) (0.90 to 1.55 mmol/L, p < 0.001) were increased, while triglycerides were decreased, after surgery (1.62 vs. 1.05 mmol/L p < 0.001). GH, IGF-1, and IGFBP-2 were not correlated with insulin or lipid parameters. Conclusions: Our study suggests that improved circulating GH and IGFBP-2 levels may mediate the beneficial effects of gastric sleeve surgery in improving insulin sensitivity and reducing insulin demand.

Objectives: Bariatric surgery provides most substantial and sustainable weight loss measures in individuals with obesity. Caloric restriction is not only intervention, changes in hormonal secretions are also leading contributory mechanisms to reduce body weight and improve the glycaemic control. The aim of this study was to evaluate the impact of gastric sleeve surgery on plasma retinol binding protein 4 (RBP4) and adipsin levels among Saudi male obese population. Methods: This prospective study was conducted in the Departments of Physiology and Surgery, College of Medicine, King Saud University. Thirty-three obese (BMI>38.3) male patients age ranged from 25 to 50 years were recruited. RBP4 and adipsin levels were analyzed before and 6-12 months after gastric sleeve surgery by ELISA along with plasma glucose, insulin, HOMA-IR and lipid profile. Results: Circulating RBP4 levels were not significantly changed by bariatric surgery (4382.85±40.35 ng before, and 4393.28±33.13 ng after surgery, p=0.842), neither did adipsin (2949.68±46.86 pg before, and 2917.90±41.90 pg after surgery, p=0.535). Segregation of study participants into two age groups, 25-35 and 35-50 years of age, revealed that before surgery older age group (35-50) had higher RBP4 levels compared to younger group (25-35) (p=0.016). However, after surgery RBP4 levels were decreased in older group but not to a significant level (p=0.174). In younger age group after surgery, there was a near significant increase in RBP4 levels (p=0.052). There were no significant changes in RBP4 levels in both age groups after surgery (p=0.461). For adipsin, there were no significant differences before and after surgery in both age groups. Insulin, BMI and HOMA-IR index were decreased after surgery, however there was no correlation with RBP4 and adipsin levels. Conclusions: The present study findings do not suggest a role for RBP4 and adipsin in the improvement of insulin sensitivity in Saudi male obese population after gastric sleeve surgery. However, a decrease in RBP4 levels in older individuals after surgery needs further investigations to understand its effect on weight and glycemic control. doi: https://doi.org/10.12669/pjms.36.7.2329 How to cite this:Alshubrami S, Al-Regaiey K, Alfadda AA, Iqbal M. Impact of Gastric Sleeve Surgery on Plasma Retinol Binding Protein 4 and Adipsin Levels in Healthy Male Population. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2329 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background Bariatric surgery is an effective treatment for severe obesity. It also ameliorates diabetes independently of weight loss through mechanisms that are not fully understood. In this study, we investigated the levels of GH, IGF-1 and IGF-binding protein 2 (IGFBP-2) after gastric sleeve surgery in healthy obese individuals. Method This study was conducted in 33 obese (BMI > 38.3) healthy male subjects aged 25 to 50 years undergoing sleeve gastrectomy. GH, IGF-1 and IGFBP-2 levels were evaluated by ELISA at baseline and 6-12 months after surgery. Other parameters, such as glucose, BMI, insulin, HOMA-IR and lipid profile, were also investigated. Results Systemic GH (12.32 vs. 50.97 pg/mL, p < 0.001) and IGFBP-2 levels (51.86 vs. 68.81 pg/mL, p < 0.001) were elevated after bariatric surgery. There was no change in IGF-1 level from before to after surgery. BMI (52.18 vs. 40.11, p = 0.001), insulin (19.35 vs. 8.80 mIU/L, p < 0.001) and HOMA-IR index (6.48 to 2.52, p < 0.001) were reduced after surgery. Lipid profile analysis revealed that total cholesterol (4.26 vs. 5.12 mmol/L, p < 0.001) and high-density lipoprotein (HDL) (0.90 to 1.55 mmol/L, p < 0.001) were increased, while triglycerides were decreased, after surgery (1.62 vs. 1.05 mmol/L p < 0.001). GH, IGF-1, and IGFBP-2 were not correlated with insulin or lipid parameters. Conclusions Our study suggests that improved circulating GH and IGFBP-2 levels may mediate the beneficial effects of gastric sleeve surgery in improving insulin sensitivity and reducing insulin demand.

Background Bariatric or weight loss surgery is an effective treatment for severe obesity. Reduced calorie intake or malabsorption are not the only mechanism, alterations in the activity of certain hormones and neurotransmitters are also the contributory mechanisms. In this study, we investigated the levels of GH, IGF-1 and IGF-binding protein (IGFBP-2) after bariatric surgery in obese individuals.Method Plasma GH, IGF-1 and IGFBP-2 levels were measured by ELISA in 33 obese (BMI >38.3) healthy male subjects age ranged from 25 to 50 years before and six months after gastric sleeve surgery. Plasma glucose, BMI, insulin, HOMA-IR and lipid profile were also investigated.Results Systemic GH (from 12.32±1.3 to 50.97±0.339 ρg/mL, P<0.001) and IGFBP-2 (51.86±11.21 to 68.81±13.36 ρg/mL, P<0.001) levels were elevated after bariatric surgery. However there was no change in IGF-1 levels. BMI (from 52.18±9.86 Kg/m2 to 40.11±8.92 Kg/m2, P<0.001), insulin (19.35±0.304 mIU/L to 8.80±0.181 mIU/L, P<0.001) and Homeostatic model assessment- Insulin resistance (HOMA-IR) index was also reduced from 6.48+0.164 to 2.52 ± 0.061 (p<0.001) were also reduced 6 months after bariatric surgery. Cholesterol, high density lipoproteins (HDL), and low density lipoproteins (LDL) levels were increased after surgery (4.26±0.027 to 5.12±0.026 mmol/L and 0.90±0.007 to 1.55±0.011 mmol/L and 2.62±0.02 to 2.98±0.022 mmol/L, P<0.001) respectively. There was no correlation between GH, IGF-1, IGFBP-2and insulin and lipid parameters.Conclusions Our study suggests that improved circulating GH and IGFBP-2 levels associated with increased levels cholesterol and triglycerides may be an endocrine response to mediate beneficial effects of bariatric surgery.

Background: Bariatric or weight loss surgery provides the most substantial and sustainable weight loss in individuals with obesity. Caloric restriction and malabsorption are not the only mechanisms by which bariatric surgery reduces body weight and improves glycemic control. Alterations in the secretion and activity of hormones are also the contributory mechanisms in bariatric surgery. We evaluated the levels of retinol binding protein 4 (RBP4) and adipsin after gastric sleeve surgery and their relationship with insulin and lipid parameters. Method: Thirty-three obese (BMI &gt; 38.3) healthy male subjects age ranged from 25 to 50 years were selected for this study. Plasma levels of RBP4 and adipsin were analyzed before and six months after gastric sleeve surgery by ELISA, along with plasma glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and lipid profile. Results: Circulating RBP4 was not significantly changed by bariatric surgery (4382.85±7.03 ng before, and 4393.28±5.769 ng after surgery, P= 0.842), neither did adipsin (2949.68±8.16 pg before, and 2917.90±7.295 pg after surgery, P=0.535). As expected, there was a reduction in BMI, insulin levels and HOMA-IR after six months of surgery. Lipid profile analysis revealed that cholesterol, high density lipoproteins (HDL), and low density lipoproteins (LDL) levels were increased after surgery (4.26±0.027 to 5.12±0.026 mmol/L and 0.90±0.007 to 1.55±0.011 mmol/L and 2.62±0.02 to 2.98±0.022 mmol/L, P&lt;0.001) respectively. However, there was no correlation between RBP4, adipsin and insulin and lipid parameters. Conclusions: Our findings do not suggest a role for RBP4 and adipsin in the improvement of insulin sensitivity in obese male population after gastric sleeve surgery. Moreover, there was no correlation between their plasma levels and either BMI, glucose, insulin, or lipid profiles. Disclosure S. Alshubrami: None. M. Iqbal: None. A. Alfadda: None. K. Alregaiey: None. Funding King Abdulaziz City for Science and Technology (1-17-03-001-0026)