The anorexigenic peptide neurotensin relates to insulin sensitivity in obese patients after BPD or RYGB metabolic surgery

Int J Obes (Lond). 2018 Dec;42(12):2057-2061. doi: 10.1038/s41366-018-0084-3. Epub 2018 May 24.


Neurotensin is a peptide with effects on appetite and intestinal lipid absorption. Experimental data suggest a role in glucose homeostasis, while human data is missing. Here, 20 morbidly obese subjects either underwent biliopancreatic diversion with duodenal switch (BPD), or Roux-en-Y gastric bypass (RYGB) in a randomized fashion. Before and 1 year after surgery, anthropometric data, body composition, clinical biochemistry, insulin sensitivity by means of euglycemic hyperinsulinemic clamps (HEC) and fasting plasma proneurotensin 1-117 were analyzed. Plasma proneurotensin increased significantly more 1 year after BDP than RYGB (P = 0.028), while weight loss was comparable. After metabolic surgery, proneurotensin correlated positively with insulin sensitivity (M-value) (r = 0.55, P < 0.001), while an inverse relationship with fasting glucose, HOMA-IR and HbA1c was observed (P < 0.05 for all components). After adjustment for age and gender, proneurotensin and BMI remained independently related with delta of M-value (β = 0.46 and β = 0.51, P < 0.05, resp.). From these data we conclude that proneurotensin positively correlates with insulin sensitivity uniquely after weight loss induced by metabolic surgery in humans. BDP leads to a stronger increase in the anorexigenic peptide compared to RYGB.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biliopancreatic Diversion / statistics & numerical data*
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Female
  • Gastric Bypass / statistics & numerical data*
  • Humans
  • Insulin Resistance / physiology*
  • Male
  • Middle Aged
  • Neurotensin / blood*
  • Obesity, Morbid* / blood
  • Obesity, Morbid* / epidemiology
  • Obesity, Morbid* / metabolism
  • Obesity, Morbid* / surgery
  • Protein Precursors / blood


  • Blood Glucose
  • Protein Precursors
  • proneurotensin
  • Neurotensin