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Bariatric Surgery

Modifications of IGF2 and EGFR plasma protein concentrations in NAFLD patients after bariatric surgery

International Journal of Obesity volume 45, pages 374–382 (2021)Cite this article

Subjects

Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is strictly associated with the epidemic of obesity and is becoming the most prevalent liver disease worldwide. In severe obesity, bariatric surgery (BS) is the most effective treatment not only for obesity but also for the associated metabolic co-morbidities, NAFLD, among others. To date, noninvasive diagnostic/prognostic methods cannot evaluate hepatic improvements following surgery.

Objectives

We aimed to measure plasma level of insulin-growth factor-2 protein (IGF2) and epithermal growth factor receptor (EGFR), and to assess their relationship with clinical and biochemical parameters during the 12 months follow-up.

Methods

Demographic, clinical–biochemical data, and plasma IGF2 and EGFR were measured in 69 patients preoperatively (T0) and 6 and 12 months (T6M and T12M, respectively) after BS. Liver biopsy was performed at T0. Relationships between IGF2, EGFR, and several biochemical parameters were performed using Pearson or Spearman correlation analysis.

Results

IGF2 plasma level increases during follow-up, passing from 2.5 (1.8–15.5) at baseline to 13.3 (8.6–19.1) at T12M, p < 0.001. Conversely, EGFR showed a not significant reduction. At T12M, the plasma level of both markers was comparable to those of lean subjects. The clinical–biochemical parameters (BMI, glycated hemoglobin, HOMA-IR) also return to the normal range at T12M. Correlation analysis demonstrated that IGF2 was significantly associated with total bilirubin, direct bilirubin, and albumin at T0 while with blood glucose, ALT, GGT, and AST/ALT ratio at T6M and T12M.

Conclusions

IGF2 plasma levels increase after bariatric surgery, and these changes are associated with the modification of hepatic biochemical parameters, even if other clinic or metabolic improvements cannot be excluded.

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Fig. 1: Plasma levels before surgery and during the follow-up.
Fig. 2: Plasma level of IGF2 at baseline and during follow-up in NAFLD patients stratified according to liver fibrosis.
Fig. 3: Plasma level of IGF2 and EGFR preoperatively and during follow-up when the cohort was stratified by surgical procedure.

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Acknowledgements

Finanziamento Ricerca di Ateneo—U05SPFRA14—FRA 2014 (CdA dd. 19.12.2014) and Fondazione Italiana Fegato. PJG by Fondazione Umberto Veronesi (Grants 2015-2017). NR is funded by Fondazione Cassa di Risparmio di Trieste (CRTrieste) and by Fondazione Italiana Fegato ONLUS.

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  1. These authors contributed equally: Silvia Palmisano, Natalia Rosso

Authors and Affiliations

  1. Fondazione Italiana Fegato, Centro Studi Fegato, Area Science Park Basovizza Bldg. Q SS14 Km 163.5, Trieste, Italy

    Pablo J. Giraudi, Claudio Tiribelli, Silvia Palmisano & Natalia Rosso

  2. UCO Clinica Chirurgica, Ospedale di Cattinara, Strada di Fiume, 447, Trieste, Italy

    Michela Giuricin, Nicolò de Manzini & Silvia Palmisano

  3. UCO Anatomia e Istologia Patologica, Ospedale di Cattinara, Strada di Fiume, 447, Trieste, Italy

    Deborah Bonazza

  4. Dipartimento Universitario di Scienze Mediche Chirurgiche e della Salute, Università degli Studi di Trieste, Strada di Fiume, 447, Trieste, Italy

    Nicolò de Manzini & Silvia Palmisano

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Giraudi, P.J., Giuricin, M., Bonazza, D. et al. Modifications of IGF2 and EGFR plasma protein concentrations in NAFLD patients after bariatric surgery. Int J Obes 45, 374–382 (2021). https://doi.org/10.1038/s41366-020-00687-0

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