Preoperative diabetes status, circulating GDF15, and weight loss after sleeve gastrectomy
In brief
Higher preoperative GDF15 predicts less weight loss after sleeve gastrectomy
In a prospective cohort of 105 patients, higher preoperative GDF15 was independently associated with lower weight loss one year after sleeve gastrectomy; average total weight loss was 32.1%. GDF15 levels rose and then returned toward baseline in patients with diabetes, but stayed elevated in those without diabetes. Whether GDF15 can reliably guide individual weight-loss estimates remains unknown.
- Journal
- Surgical endoscopy (Q1)
- Published
- 9 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Yu-Yang Lee, Young-Jen Lin, Wei-Shiung Yang, Po-Chu Lee, Chiung-Nien Chen, Ming-Tsan Lin, et al.
- PMID
- 42855511
- DOI
- 10.1007/s00464-026-13491-0
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 12 October 2026): Preop GDF15 predicts weight loss after sleeve gastrectomy
Abstract
BACKGROUND: Growth differentiation factor 15 (GDF15) is a stress-responsive cytokine implicated in metabolic stress, appetite regulation, and energy homeostasis. However, longitudinal GDF15 changes after metabolic bariatric surgery remain inconsistent, and whether preoperative type 2 diabetes (T2D) modifies postoperative GDF15 trajectories after sleeve gastrectomy (SG) is unclear. METHODS: In this prospective, single-center observational cohort, 105 patients with severe obesity undergoing laparoscopic SG between 2018 and 2022 were studied. Circulating GDF15 and clinical variables were measured preoperatively and at 6 months and 1 year after SG. Patients were stratified by preoperative T2D status. Associations between baseline GDF15 and 1-year total weight loss percentage (TWL%) were assessed using stepwise multivariable linear regression. RESULTS: Participants were 53 males, mean age 39.3 ± 10.4 years, and BMI 40.4 ± 5.4 kg/m2; 52 had preoperative T2D. GDF15 increased at 6 months after SG (699.3 ± 454.7 to 849.2 ± 596.2 pg/mL, p = 0.002) but returned toward baseline at 1 year (739.3 ± 490.3 pg/mL, p = 0.327). Patients with preoperative T2D had higher baseline GDF15 levels compared to those without diabetes (843.8 ± 503.4 vs. 557.5 ± 351.6 pg/mL, p = 0.001), with a transient increase at 6 months (1020.6 ± 678.2 pg/mL, p = 0.018) that returned to baseline at 1 year (830.6 ± 581.5 pg/mL, p = 0.854). In contrast, patients without T2D exhibited a sustained increase of GDF15 levels at 6 months (681.0 ± 449.0 pg/mL, p = 0.037) and 1 year (649.7 ± 364.3 pg/mL, p = 0.022). Mean 1-year TWL% was 32.1 ± 7.7%. Higher baseline GDF15 independently predicted lower 1-year TWL% in multivariate analyses. CONCLUSIONS: After SG, circulating GDF15 follows distinct trajectories according to preoperative T2D status. Baseline GDF15 may help characterize individual variability in metabolic adaptation and weight loss after SG.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.