Surgery-Induced Weight Loss and Changes in Hormonally Active Fibroblast Growth Factors: a Systematic Review and Meta-Ana
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REVIEW
Surgery-Induced Weight Loss and Changes in Hormonally Active Fibroblast Growth Factors: a Systematic Review and Meta-Analysis Ali Hosseinzadeh 1 & Leonardo Roever 2 & Shahab Alizadeh 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This systematic review and meta-analysis was performed to investigate the possible changes of FGF-19 and FGF-21 after bariatric surgery (BS). Electronic databases including PubMed and Scopus were systematically searched up to February 2020 to identify pertinent studies. A total of 25 different studies were included. The overall pooled analysis identified that BS caused a significant increase in FGF-19, but had no significant effect on FGF-21. For FGF-19, this finding was supported in the subgroup analyses. For FGF-21, Roux-en-Y gastric bypass (RYGB) surgery significantly increased FGF-21 levels, whereas, in studies with follow-up duration ≥ 1 year, FGF-21 levels decreased significantly. BS reduces circulating concentration of FGF-19, but might increase FGF-21 after RYGB or decrease FGF-21 after ≥ 1 year. Keywords Bariatric surgery . Obesity . Weight loss . Fibroblast growth factor . FGF-19 . FGF-21
Introduction The prevalence of obesity has increased dramatically over the past decades worldwide representing a main threat for public health [1]. Obesity is accompanied by many metabolic complications such as endocrine dysregulations, insulin resistance, dyslipidemia, cardiovascular disease, nonalcoholic fatty liver disease, and subclinical inflammation resulting in a rise in morbidity and mortality [2]. Unfortunately, traditional approaches, such as diets and exercise, have not been so effective for the long-term management of weight, particularly in severe obese patients [3]. Bariatric surgery (BS) is presently the most Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04807-7) contains supplementary material, which is available to authorized users. * Shahab Alizadeh [email protected] 1
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
2
Department of Clinical Research, Federal University of Uberlândia, Uberlândia, Brazil
3
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
effective therapeutic approach for severe obesity, yielding an improvement in its comorbidities, such as type 2 diabetes [2]. In addition to classical pathogenic factors, fibroblast growth factor 19 (FGF-19), the human ortholog of FGF-15 in the mouse, and FGF-21 are novel metabolically active hormones that have been intensively investigated given their therapeutic potential in obesity and metabolic recovery following BS, particularly for diabetes [4]. FGF-19 is produced primarily in enterocytes of distal ileum [5], while FGF-21 is secreted predominantly in the liver with lower secretion rates in the muscle, adipose tissue, and pancreas [6]. Both FGF-19 and FGF-21 are metabolic regulators of
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