Analysis of Gremlin 1 Levels Following Sleeve Gastrectomy

In the current study, we aimed to assess the levels of Gremlin 1, an adipokine with a rich repertoire of metabolic effects, in association with the glycemic and lipid parameters after sleeve gastrectomy.

This study was conducted on 31 males with obesity aged 25 to 50 years who underwent sleeve gastrectomy. Plasma Gremlin 1 levels were evaluated using enzyme-linked immunosorbent assay (ELISA) at baseline and 6-12 months after the operation, along with body mass index, insulin, glucose, and lipid profile.

Plasma Gremlin 1 levels were elevated (148.19±17.43 vs. 193.29±19.82 ng/mL, p < 0.05) after sleeve gastrectomy. This was accompanied by a decrease in body mass index (from 51.47±1.71 to 39.23±1.56 kg/m², p < 0.05). Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) also exhibited a significant decrease (19.69±1.81 vs. 8.98±1.09 mIU/L and 6.52±0.98 vs. 2.57±0.036 p < 0.05, respectively) in the postoperative period. Total cholesterol levels were significantly increased after surgery (4.29±0.16 to 5.10±0.16, p < 0.05). Pearson correlation analysis showed that Gremlin 1 was positively correlated with insulin before surgery, but there was no significant correlation after surgery.

The circulating Gremlin 1 levels were elevated postoperatively among our participants. The improvement in insulin sensitivity appears to be independent of the reported antagonistic effects of Gremlin 1.