1. Identification of Proteins Associated with the Early Restoration of Insulin Sensitivity After Biliopancreatic Diversion
- Author
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Karlsson, C., Wallenius, K., Walentinsson, A., Greasley, P. J., Miliotis, T., Hammar, M., Iaconelli, Amerigo, Tapani, S., Raffaelli, Marco, Mingrone, Geltrude, Carlsson, B., Iaconelli A., Raffaelli M. (ORCID:0000-0002-1259-2491), Mingrone G. (ORCID:0000-0003-2021-528X), Karlsson, C., Wallenius, K., Walentinsson, A., Greasley, P. J., Miliotis, T., Hammar, M., Iaconelli, Amerigo, Tapani, S., Raffaelli, Marco, Mingrone, Geltrude, Carlsson, B., Iaconelli A., Raffaelli M. (ORCID:0000-0002-1259-2491), and Mingrone G. (ORCID:0000-0003-2021-528X)
- 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.
- Published
- 2020