Differential effects of bariatric surgery on plasma levels of ANGPTL3 and ANGPTL4

Angiopoietin-like 3 (ANGPTL3) and 4 (ANGPTL4) are regulators of triglyceride storage and utilization. Bariatric surgery (BS) leads to profound changes in adipose tissue composition and energy metabolism. We evaluated the impact of BS on plasma levels of ANGPTL3 and ANGPTL4. Twenty-seven subjects aff...

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Published in:Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2022-11, Vol.32 (11), p.2647-2654
Main Authors: Bini, Simone, D'Erasmo, Laura, Astiarraga, Brenno, Minicocci, Ilenia, Palumbo, Maria, Pecce, Valeria, Polito, Luca, Di Costanzo, Alessia, Haeusler, Rebecca A., Arca, Marcello, Ferrannini, Ele, Camastra, Stefania
Format: Article
Language:English
Subjects:
Angiopoietin-Like Protein 3
Angiopoietin-Like Protein 4 - genetics
Angiopoietin-like Proteins - metabolism
Angiopoietins
ANGPTL3
ANGPTL4
Bariatric surgery
Bariatric Surgery - adverse effects
Bile Acids and Salts
Blood Glucose - metabolism
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - surgery
Fatty Acids, Nonesterified
Gastric Bypass - adverse effects
Humans
Insulin Resistance
Insulin sensitivity
Lipid metabolism
Obesity, Morbid - diagnosis
Obesity, Morbid - surgery
Triglycerides
Type 2 diabetes mellitus
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Summary:Angiopoietin-like 3 (ANGPTL3) and 4 (ANGPTL4) are regulators of triglyceride storage and utilization. Bariatric surgery (BS) leads to profound changes in adipose tissue composition and energy metabolism. We evaluated the impact of BS on plasma levels of ANGPTL3 and ANGPTL4. Twenty-seven subjects affected by morbid obesity with or without type 2 diabetes (T2D) underwent Roux-en-Y gastric bypass (RYGB) and 18 patients with advanced T2D received Biliopancreatic Diversion (BPD). Fasting ANGPTL proteins levels, insulin sensitivity (evaluated by euglycemic hyperinsulinemic clamp), total bile acids (TBA) and free fatty acids (FFA) were measured at baseline and 1 year after surgery. Both surgical procedures resulted in the loss of fat mass, improved glucose control, and a ∼2-fold increase of insulin sensitivity. ANGPTL4 levels decreased significantly with both RYGB (26.6 ± 0.6 to 24.4 ± 0.3 ng/mL, p = 0.001) and BPD (27.9 ± 1.5 to 24.0 ± 0.5 ng/mL, p = 0.003). In contrast, ANGPTL3 concentrations did not change after RYGB but rose following BPD (225 ± 20 to 300 ± 15 ng/mL, p = 0.003). By multiple regression analysis, changes after BS in ANGPTL4 were independently associated with changes in blood glucose, (p = 0.0169) whereas changes in ANGPTL3 were associated with variations in FFA (p = 0.008) and insulin sensitivity (p = 0.043). Circulating ANGPTL4 is reduced by BS, probably due to the loss of fat mass and improved insulin sensitivity. Conversely, ANGPTL3 levels increased after BPD, but not after RYGB, presumably because of the metabolic changes induced by the malabsorptive effect of BPD. •BPD and RYGB cause a reduction in ANGPTL4 levels.•ANGPTL3 increases after BPD but not after RYGB.•ANGPTL3 increase in BPD is associated with FFA reduction.•Insulin sensitivity is directly related to ANGPTL3 and inversely related to ANGPTL4.
ISSN:0939-4753
1590-3729
DOI:10.1016/j.numecd.2022.08.019