IGFBP-2 partly mediates the early metabolic improvements caused by bariatric surgery

Insulin-like growth factor-binding protein (IGFBP)-2 is a circulating biomarker of cardiometabolic health. Here, we report that circulating IGFBP-2 concentrations robustly increase after different bariatric procedures in humans, reaching higher levels after biliopancreatic diversion with duodenal switch (BPD-DS) than after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). This increase is closely associated with insulin sensitization. In mice and rats, BPD-DS and RYGB operations also increase circulating IGFBP-2 levels, which are not affected by SG or caloric restriction. In mice, Igfbp2 deficiency significantly impairs surgery-induced loss in adiposity and early improvement in insulin sensitivity but does not affect long-term enhancement in glucose homeostasis. This study demonstrates that the modulation of circulating IGFBP-2 may play a role in the early improvement of insulin sensitivity and loss of adiposity brought about by bariatric surgery. [Display omitted] IGFBP-2 is modulated by different bariatric surgeries in both human and rodentsIn humans, IGFBP-2 levels are closely related to insulin sensitizationIn mice, IGFBP-2 partly mediates surgery-induced weight lossIGFBP-2 is implicated in surgery-induced early improvements in glucose homeostasis Faramia et al. show that the robust increase in IGFBP-2 levels is a common feature of bariatric procedures in humans and rodents. In patients, this increase closely correlates with insulin sensitization. In mice, IGFBP-2 deficiency partly impairs weight loss and early improvements in glucose homeostasis induced by Roux-en-Y surgery.