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

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Harvard

Mulla, CM, Goldfine, AB, Dreyfuss, JM, Houten, S, Pan, H, Pober, DM, Wewer Albrechtsen, NJ, 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., ... 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

CBE

Mulla CM, Goldfine AB, Dreyfuss JM, Houten S, Pan H, Pober DM, Wewer Albrechtsen NJ, 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. 29(7):2092-2099. https://doi.org/10.1007/s11695-019-03845-0

MLA

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 Jul;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 ; Wewer Albrechtsen, Nicolai J ; 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{0d51ad867e32401f9e281c85c4f2ea92,
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, 1094 ± 141 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 = "Bile acids, FGF-19, Gastric bypass, Hypoglycemia",
author = "Mulla, {Christopher M} and Goldfine, {Allison B} and Dreyfuss, {Jonathan M} and Sander Houten and Hui Pan and Pober, {David M} and {Wewer Albrechtsen}, {Nicolai J} 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",
month = "7",
doi = "10.1007/s11695-019-03845-0",
language = "English",
volume = "29",
pages = "2092--2099",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer New York LLC",
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 - Wewer Albrechtsen, Nicolai J

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 - 2019/7

Y1 - 2019/7

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, 1094 ± 141 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, 1094 ± 141 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 - Bile acids

KW - FGF-19

KW - Gastric bypass

KW - Hypoglycemia

UR - http://www.scopus.com/inward/record.url?scp=85064456593&partnerID=8YFLogxK

U2 - 10.1007/s11695-019-03845-0

DO - 10.1007/s11695-019-03845-0

M3 - Journal article

VL - 29

SP - 2092

EP - 2099

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 7

ER -

ID: 56976952