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Updated: Oct 11, 2026

Sleeve Gastrectomy in Mice using Surgical Clips
Published on: November 14, 2020
Preoperative diabetes status, circulating GDF15, and weight loss after sleeve gastrectomy
Yu-Yang Lee1, Young-Jen Lin1, Wei-Shiung Yang2,3,4
1Department of Surgery, National Taiwan University Hospital, No.7, Chung Shan S. Rd., Zhongzheng District, Taipei, 100, Taiwan.
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.
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