Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia. / Mulla, Christopher M.; Goldfine, Allison B.; Dreyfuss, Jonathan M.; Houten, Sander; Pan, Hui; Pober, David M.; Albrechtsen, Nicolai J. Wewer; Svane, Maria S.; Schmidt, Julie B.; Holst, Jens Juul; Craig, Colleen M.; McLaughlin, Tracey L.; Patti, Mary-Elizabeth.

In: Obesity Surgery, Vol. 29, No. 7, 2019, p. 2092-2099.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Mulla, CM, Goldfine, AB, Dreyfuss, JM, Houten, S, Pan, H, Pober, DM, Albrechtsen, NJW, Svane, MS, Schmidt, JB, Holst, JJ, Craig, CM, McLaughlin, TL & Patti, M-E 2019, 'Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia', Obesity Surgery, vol. 29, no. 7, pp. 2092-2099. https://doi.org/10.1007/s11695-019-03845-0

APA

Mulla, C. M., Goldfine, A. B., Dreyfuss, J. M., Houten, S., Pan, H., Pober, D. M., Albrechtsen, N. J. W., Svane, M. S., Schmidt, J. B., Holst, J. J., Craig, C. M., McLaughlin, T. L., & Patti, M-E. (2019). Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia. Obesity Surgery, 29(7), 2092-2099. https://doi.org/10.1007/s11695-019-03845-0

Vancouver

Mulla CM, Goldfine AB, Dreyfuss JM, Houten S, Pan H, Pober DM et al. Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia. Obesity Surgery. 2019;29(7):2092-2099. https://doi.org/10.1007/s11695-019-03845-0

Author

Mulla, Christopher M. ; Goldfine, Allison B. ; Dreyfuss, Jonathan M. ; Houten, Sander ; Pan, Hui ; Pober, David M. ; Albrechtsen, Nicolai J. Wewer ; Svane, Maria S. ; Schmidt, Julie B. ; Holst, Jens Juul ; Craig, Colleen M. ; McLaughlin, Tracey L. ; Patti, Mary-Elizabeth. / Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia. In: Obesity Surgery. 2019 ; Vol. 29, No. 7. pp. 2092-2099.

Bibtex

@article{4cb932a2fdf5435781f0444745015d78,
title = "Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia",
abstract = "Background Hypoglycemia is an increasingly recognized complication of bariatric surgery. Mechanisms contributing to glucose lowering remain incompletely understood. We aimed to identify differentially abundant plasma proteins in patients with post-bariatric hypoglycemia (PBH) after Roux-en-Y gastric bypass (RYGB), compared to asymptomatic post-RYGB. Methods Proteomic analysis of blood samples collected after overnight fast and mixed meal challenge in individuals with PBH, asymptomatic RYGB, severe obesity, or overweight recruited from outpatient hypoglycemia or bariatric clinics. Results The top-ranking differentially abundant protein at 120 min after mixed meal was fibroblast growth factor 19 (FGF-19), an intestinally derived hormone regulated by bile acid-FXR signaling; levels were 2.4-fold higher in PBH vs. asymptomatic post-RYGB (mean +/- SEM, 1094141 vs. 428 +/- 45, P < 0.001, FDR < 0.01). FGF-19 ELISA confirmed 3.5-fold higher concentrations in PBH versus asymptomatic (360 +/- 70 vs. 103 +/- 18, P = 0.025). To explore potential links between increased FGF-19 and GLP-1, residual samples from other human studies in which GLP-1 was modulated were assayed. FGF-19 levels did not change in response to infusion of GLP-1 and PYY in overweight/obese individuals. Infusion of the GLP-1 receptor antagonist exendin 9-39 in recently operated asymptomatic post-RYGB did not alter FGF-19 levels after mixed meal. By contrast, GLP-1 receptor antagonist infusion yielded a significant increase in FGF-19 levels after oral glucose in individuals with PBH. While plasma bile acids did not differ between PBH and asymptomatic post-RYGB, these data suggest unique interrelationships between GLP-1 and FGF-19 in PBH. Conclusions Taken together, these data support FGF-19 as a potential contributor to insulin-independent pathways driving postprandial hypoglycemia in PBH.",
keywords = "Gastric bypass, Hypoglycemia, FGF-19, Bile acids",
author = "Mulla, {Christopher M.} and Goldfine, {Allison B.} and Dreyfuss, {Jonathan M.} and Sander Houten and Hui Pan and Pober, {David M.} and Albrechtsen, {Nicolai J. Wewer} and Svane, {Maria S.} and Schmidt, {Julie B.} and Holst, {Jens Juul} and Craig, {Colleen M.} and McLaughlin, {Tracey L.} and Mary-Elizabeth Patti",
year = "2019",
doi = "10.1007/s11695-019-03845-0",
language = "English",
volume = "29",
pages = "2092--2099",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer",
number = "7",

}

RIS

TY - JOUR

T1 - Plasma FGF-19 Levels are Increased in Patients with Post-Bariatric Hypoglycemia

AU - Mulla, Christopher M.

AU - Goldfine, Allison B.

AU - Dreyfuss, Jonathan M.

AU - Houten, Sander

AU - Pan, Hui

AU - Pober, David M.

AU - Albrechtsen, Nicolai J. Wewer

AU - Svane, Maria S.

AU - Schmidt, Julie B.

AU - Holst, Jens Juul

AU - Craig, Colleen M.

AU - McLaughlin, Tracey L.

AU - Patti, Mary-Elizabeth

PY - 2019

Y1 - 2019

N2 - Background Hypoglycemia is an increasingly recognized complication of bariatric surgery. Mechanisms contributing to glucose lowering remain incompletely understood. We aimed to identify differentially abundant plasma proteins in patients with post-bariatric hypoglycemia (PBH) after Roux-en-Y gastric bypass (RYGB), compared to asymptomatic post-RYGB. Methods Proteomic analysis of blood samples collected after overnight fast and mixed meal challenge in individuals with PBH, asymptomatic RYGB, severe obesity, or overweight recruited from outpatient hypoglycemia or bariatric clinics. Results The top-ranking differentially abundant protein at 120 min after mixed meal was fibroblast growth factor 19 (FGF-19), an intestinally derived hormone regulated by bile acid-FXR signaling; levels were 2.4-fold higher in PBH vs. asymptomatic post-RYGB (mean +/- SEM, 1094141 vs. 428 +/- 45, P < 0.001, FDR < 0.01). FGF-19 ELISA confirmed 3.5-fold higher concentrations in PBH versus asymptomatic (360 +/- 70 vs. 103 +/- 18, P = 0.025). To explore potential links between increased FGF-19 and GLP-1, residual samples from other human studies in which GLP-1 was modulated were assayed. FGF-19 levels did not change in response to infusion of GLP-1 and PYY in overweight/obese individuals. Infusion of the GLP-1 receptor antagonist exendin 9-39 in recently operated asymptomatic post-RYGB did not alter FGF-19 levels after mixed meal. By contrast, GLP-1 receptor antagonist infusion yielded a significant increase in FGF-19 levels after oral glucose in individuals with PBH. While plasma bile acids did not differ between PBH and asymptomatic post-RYGB, these data suggest unique interrelationships between GLP-1 and FGF-19 in PBH. Conclusions Taken together, these data support FGF-19 as a potential contributor to insulin-independent pathways driving postprandial hypoglycemia in PBH.

AB - Background Hypoglycemia is an increasingly recognized complication of bariatric surgery. Mechanisms contributing to glucose lowering remain incompletely understood. We aimed to identify differentially abundant plasma proteins in patients with post-bariatric hypoglycemia (PBH) after Roux-en-Y gastric bypass (RYGB), compared to asymptomatic post-RYGB. Methods Proteomic analysis of blood samples collected after overnight fast and mixed meal challenge in individuals with PBH, asymptomatic RYGB, severe obesity, or overweight recruited from outpatient hypoglycemia or bariatric clinics. Results The top-ranking differentially abundant protein at 120 min after mixed meal was fibroblast growth factor 19 (FGF-19), an intestinally derived hormone regulated by bile acid-FXR signaling; levels were 2.4-fold higher in PBH vs. asymptomatic post-RYGB (mean +/- SEM, 1094141 vs. 428 +/- 45, P < 0.001, FDR < 0.01). FGF-19 ELISA confirmed 3.5-fold higher concentrations in PBH versus asymptomatic (360 +/- 70 vs. 103 +/- 18, P = 0.025). To explore potential links between increased FGF-19 and GLP-1, residual samples from other human studies in which GLP-1 was modulated were assayed. FGF-19 levels did not change in response to infusion of GLP-1 and PYY in overweight/obese individuals. Infusion of the GLP-1 receptor antagonist exendin 9-39 in recently operated asymptomatic post-RYGB did not alter FGF-19 levels after mixed meal. By contrast, GLP-1 receptor antagonist infusion yielded a significant increase in FGF-19 levels after oral glucose in individuals with PBH. While plasma bile acids did not differ between PBH and asymptomatic post-RYGB, these data suggest unique interrelationships between GLP-1 and FGF-19 in PBH. Conclusions Taken together, these data support FGF-19 as a potential contributor to insulin-independent pathways driving postprandial hypoglycemia in PBH.

KW - Gastric bypass

KW - Hypoglycemia

KW - FGF-19

KW - Bile acids

U2 - 10.1007/s11695-019-03845-0

DO - 10.1007/s11695-019-03845-0

M3 - Journal article

C2 - 30976983

VL - 29

SP - 2092

EP - 2099

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 7

ER -

ID: 226791238