Biphasic changes in angiopoietin-like 8 level after laparoscopic sleeve gastrectomy and type 2 diabetes remission during a 1-year follow-up

Abstract Angiopoietin-like 8 (ANGPTL8) a hepatic protein, implicated by several studies with a role in promoting pancreatic β-cell proliferation and improving glucose tolerance. Although a matter of controversy, a growing number of reports support ANGPTL8's potential, yet unclear role in type 2 diabetes mellitus (T2D). Objectives To examine changes in fasting ANGPTL8 level in people with morbid obesity, with or without diabetes following laparoscopic sleeve gastrectomy (LSG) in 1-year prospective study. Methods Fasting serum ANGPTL8 was measured by ELISA at baseline in participants with morbid obesity, 17 with diabetes and 23 without diabetes, and in normal weight participants, 19 with and 15 without diabetes, and during 1-year post-LSG in participants with morbid obesity. Results At baseline, people with T2D had higher ANGPTL8 level, (morbid obese, Mean ±SEM; 1415 ±196.4 pg/ml, and normal-weight, 2231 ±328.1 pg/ml), compared with individuals without T2D (morbid obese, 876 ±155.0 pg/ml, and normal weight controls 868.9 ±218.7 pg/ml). In participants with diabetes and morbid obesity, T2D remission occurred 15 days post-LSG, defined by a sustained reduced fasting blood glucose levels P ), followed by a gradual decrease to reach almost the baseline level (day 360, 1184 ±119.3 pg/ml). Conclusion Elevated baseline ANGPTL8 in participants with diabetes at baseline reflected a link to T2D. Interestingly, the unique biphasic pattern of change in fasting ANGPTL8 post-LSG, occurred only in people with diabetes, suggesting ANGPTL8's potential role in T2D remission.