Diabetologie und Stoffwechsel 2017; 12(S 01): S1-S84
DOI: 10.1055/s-0037-1601622
Vorträge
Endokrine Dysfunktionen bei Adipositas (zusammen mit der DGE)
Georg Thieme Verlag KG Stuttgart · New York

Circulating proneurotensin is related to insulin sensitivity in human subjects after metabolic surgery

C von Loeffelholz
1   Jena University Hospital, Department of Anesthesiology and Intensive Care, Jena, Germany
2   German Institute of Human Nutrition (DIfE), Department of Clinical Nutrition, Potsdam-Rehbrücke, Germany
,
G Mingrone
3   Catholic University Rome, Department of Internal Medicine, Rome, Italy
4   King's College London, Diabetes and Nutritional Sciences, London, United Kingdom
,
AL Birkenfeld
4   King's College London, Diabetes and Nutritional Sciences, London, United Kingdom
5   University Hospital Carl Gustav Carus, Section of Metabolic and Vascular Medicine, Medical Clinic III, Dresden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
05 May 2017 (online)

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Aims:

Neurotensin is a gastrointestinal peptide affecting appetite and lipid absorption, while proneurotensin represents its stable precursor and is produced at stoichiometric amounts. Recent animal data suggest a role for neurotensin in glucose homeostasis, but associations with human insulin sensitivity have not been examined.

Methods:

We studied 20 morbid obese subjects (Clinical-Trials.gov Identifier: NCT01581801) undergoing biliopancreatic diversion with duodenal switch (BPD) or Roux-en-Y gastric bypass (RYGB). Before and one year after metabolic surgery anthropometric data were evaluated, body composition was measured by dual-energy X-ray absorptiometry (DEXA), clinical biochemistry was analysed and peripheral insulin sensitivity was studied by the euglycemic hyperinsulinemic glucose-clamp technique. Insulin resistance was calculated by the homeostasis-model assessment of insulin resistance (HOMA-IR). Fasting proneurotensin was analysed by enzyme-linked immunosorbent assay.

Results:

A significant correlation of proneurotensin with M-value became apparent after surgery (rSpearman= 0.55, P < 0.001), while an inverse relationship with fasting glucose (rSpearman=-0.54, P < 0.001), HOMA-IR (rSpearman=-0.37, P= 0.020) and HbA1c (rSpearman=-0.44, P= 0.005) was observed. Furthermore, proneurotensin correlated with total and low density lipoprotein (LDL) cholesterol (rSpearman=-0.50, P= 0.001 and rSpearman=-0.60, P < 0.001, respectively).

Fasting proneurotensin increased one year after metabolic surgery (P Wilcoxon < 0.001). Stratification according to RYGB vs. BPD showed a comparable loss of body weight and BMI (P Wilcoxon > 0.05, respectively), but the rise in plasma proneurotensin was remarkably higher after BPD (P Wilcoxon= 0.028).

Conclusion:

Proneurotensin relates to insulin sensitivity in morbidly obese humans.