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 aimed at evaluating its levels following different bariatric procedures, and whether it directly contributes to their beneficial effects on body weight and glucose homeostasis. In humans, plasma IGFBP-2 levels increased to higher levels after biliopancreatic diversion with duodenal switch (BPD-DS), compared to Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). This increase was closely associated with insulin sensitization. In mice and rats, BPD-DS and RYGB operations also increased circulating IGFBP-2 levels, which were not affected by SG or caloric restriction. In mice, Igfbp2 deficiency significantly blunted surgery-induced loss in adiposity and early improvement in insulin sensitivity but did not impact long-term enhancement in glucose homeostasis. This study demonstrated 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.