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. 2020 Aug 12;9(8):2614.
doi: 10.3390/jcm9082614.

Altered GH-IGF-1 Axis in Severe Obese Subjects is Reversed after Bariatric Surgery-Induced Weight Loss and Related with Low-Grade Chronic Inflammation

Paula Juiz-Valiña  1   2   3 , Lara Pena-Bello  1   2 , Maria Cordido  1   2 , Elena Outeiriño-Blanco  4 , Sonia Pértega  5 , Barbara Varela-Rodriguez  1   2 , Maria Jesus Garcia-Brao  6 , Enrique Mena  5 , Susana Sangiao-Alvarellos  1   2   3 , Fernando Cordido  1   2   3   4
Affiliations

Altered GH-IGF-1 Axis in Severe Obese Subjects is Reversed after Bariatric Surgery-Induced Weight Loss and Related with Low-Grade Chronic Inflammation

Paula Juiz-Valiña et al. J Clin Med. .

Abstract

Endocrine disorders are common in obesity, including altered somatotropic axis. Obesity is characterized by reduced growth hormone (GH) secretion, although the insulin-like growth factor-1 (IGF-1) values are controversial. The aim of this study was to evaluate the effect of weight loss after bariatric surgery in the GH-IGF-1 axis in extreme obesity, in order to investigate IGF-1 values and the mechanism responsible for the alteration of the GH-IGF-1 axis in obesity. We performed an interventional trial in morbidly obese patients who underwent bariatric surgery. We included 116 patients (97 women) and 41 controls (30 women). The primary endpoint was circulating GH and IGF-1 values. Circulating IGF-1 values were lower in the obese patients than in the controls. Circulating GH and IGF-1 values increased significantly over time after surgery. Post-surgery changes in IGF-1 and GH values were significantly negatively correlated with changes in C-reactive protein (CRP) and free T4 values. After adjusting for preoperative body mass index (BMI), free T4 and CRP in a multivariate model, only CRP was independently associated with IGF-1 values in the follow-up. In summary, severe obesity is characterized by a functional hyposomatotropism at central and peripheral level that is progressively reversible with weight loss, and low-grade chronic inflammation could be the principal mediator.

Keywords: GH; IGF-1; bariatric surgery; endocrine disorders; obesity; somatotropic axis.

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Conflict of interest statement

The authors declare no conflict of interest. Data Availability: All of the data analyzed during this study are included in this manuscript as well as in a previously-published article cited in the references. If any further information is required, please contact the corresponding author.

Figures

Figure 1
Figure 1
Insulin-like growth factor 1 (IGF-1) and growth hormone (GH) values (Median (IR)) in control subjects and obese patient before and twelve months after bariatric surgery.
Figure 2
Figure 2
Evolution over time of IGF-1 and GH values (Median (IR)) before and after surgery (zero, one, three, six and twelve months).
Figure 3
Figure 3
Repeated measures correlation for the overall relationship between changes in IGF-1 and (a) excessive BMI loss (EBMIL), (b) TSH, (c) free T4, (d) fasting glucose, (e) HOMA-IR, (f) C-reactive protein, (g) fasting insulin and (h) C-peptide. Obese subjects are represented by points that correspond to pre- and post-operative IGF-1 levels and the respective anthropometric, biochemical and hormonal data. Each line represents the correlation adjustment of repeated measures for each participant.
Figure 4
Figure 4
Repeated measures correlation for the overall relationship between changes in GH and (a) EBMIL, (b) TSH, (c) free T4, (d) fasting glucose, (e) HOMA-IR, (f) C-reactive protein, (g) fasting insulin and (h) C-peptide. Obese subjects are represented by points that correspond to pre- and post-operative IGF-1 levels and the respective anthropometric, biochemical and hormonal data. Each line represents the correlation adjustment of repeated measures for each participant.
See this image and copyright information in PMC

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