Sleeve Gastrectomy Preferentially Increases GDF15 Plasma Levels in Patients With Obesity but Without Metabolic Syndrome

The mechanisms by which bariatric/metabolic surgery induces weight loss and the amelioration of obesity-associated complications are far from being fully elucidated. Variations in circulating hormones involved in the regulation of energy balance are usually considered to explain the effects of surgery beyond the restrictive mechanism. Recent studies have shown that gastric bypass modulates the plasma levels of GDF15, a molecule with anorectic action potentially contributing to the body weight reduction observed after surgery. Here, we report that sleeve gastrectomy has different effects on GDF15 plasma levels in patients with obesity depending on the presence of metabolic syndrome (MetS). Patients with MetS showed higher GDF15 plasma levels at baseline, but they had no increase in hormone concentrations compared to patients without MetS. Furthermore, at baseline, a correlation between blood glucose and GDF15 was observed in patients with MetS, and between plasma insulin and GDF15 in patients without MetS. Considering this data, GDF15 seems a molecule reflecting the severity of metabolic derangements not directly involved in mechanisms of surgical weight loss, and its role in obesity physiopathology and treatment needs to be further investigated.