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Abstract: SA-PO337

Bariatric Surgery Alters Fibroblast Growth Factor 21 and the Renin Angiotensin System in Patients with Obesity

Session Information

Category: Hypertension and CVD

  • 1403 Hypertension and CVD: Mechanisms

Authors

  • Yu, Byung chul, Soonchunhyang University Bucheon Hospital, Republic of Korea, Bucheon, Korea (the Republic of)
  • Kim, Hyoshik, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea, Seoul, Korea (the Republic of)
  • Kim, Yon hee, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea, Seoul, Korea (the Republic of)
  • Noh, Hyunjin, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea, Seoul, Korea (the Republic of)
  • Park, Moo Yong, Soonchunhyang University Bucheon Hospital, Republic of Korea, Bucheon, Korea (the Republic of)
  • Kwon, Soon hyo, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea, Seoul, Korea (the Republic of)
Background

Obesity is associated with overactivation of the renin-angiotensin system (RAS). Recent studies have shown that fibroblast growth factor 21 (FGF21) prevents angiotensin II (Ang II) induced hypertension and vascular dysfunction by activation of the angiotensin-converting enzyme 2 (ACE2)/Angiotensin 1-7 (Ang (1-7))/MAS axis in hypertension. However, it is not certain whether bariatric surgery changes FGF21/RAS in morbid obesity. In this study, we examined the relationship between circulating FGF21 and Ang II/ACE2/Ang (1-7) in patients with obesity after bariatric surgery.

Methods

We prospectively enrolled obese patient who underwent bariatric surgery and age-sex matched healthy volunteers (HVs) (n=12 each). Serum FGF-21, Ang II, ACE2, and Ang (1-7) levels were measured by enzyme-linked immunosorbent assay kits. We measured also FGF-21, Ang II, ACE2, and Ang (1-7) 6 months after bariatric surgery in obese patients (n=12).

Results

Ang II and ACE2 levels were significantly higher in obese patients compared with HVs (931.9 ± 189.2 vs 615.2 ± 79.9 pg/mL, p < 0.001, 273.8 ± 45.0 vs 240.8 ± 42.3 ng/mL, p = 0.020, respectively). Ang II and ACE2 levels were significantly decreased after bariatric surgery (p = 0.005, 0.023, respectively). In obese patients, FGF 21 levels was higher compared with HV (p = 0.034) and decreased after bariatric surgery (p = 0.002). There was no significant difference in Ang (1-7) levels between obese patients and HVs (p = 0.887). Although Ang (1-7) levels did not change after bariatric surgery (p = 0.480), changes in Ang (1-7) levels were positively correlated with changes in body mass index (BMI) (R2 = 0.580, p = 0.048)(Fig 1).

Conclusion

Bariatric surgery reduced the elevated systemic Ang II, FGF21 and ACE2 levels in obese patients. A decrease in BMI after bariatric surgery was associated with a reduction in Ang (1-7) levels.