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

Research output: Contribution to journalJournal articleResearchpeer-review

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., Wewer Albrechtsen, N. J., 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

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 = jul,
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

C2 - 30976983

VL - 29

SP - 2092

EP - 2099

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - 7

ER -

ID: 56976952