Supplemental Materials: Identification of proteins associated with the early restoration of insulin sensitivity after biliopancreatic diversion

ABSTRACT CONTEXT: Insulin resistance (IR) is a risk factor for type 2
diabetes, diabetic kidney disease, cardiovascular disease and
non-alcoholic steatohepatitis. Biliopancreatic diversion (BPD) is the most
effective form of bariatric surgery for improving insulin sensitivity.
OBJECTIVE: To identify plasma proteins correlating with the early
restoration of insulin sensitivity after BPD. DESIGN: Prospective single
centre study including twenty insulin resistant men with morbid obesity
scheduled for BPD. Patient characteristics and blood samples were
repeatedly collected from baseline up to four weeks post-surgery. IR was
assessed by HOMA-IR, Matsuda Index and by studying metabolic profiles
during meal tolerance tests. Unbiased proteomic analysis was performed to
identify plasma proteins altered by BPD. Detailed plasma profiles were
made on a selected set of proteins by targeted multiple reaction
monitoring mass spectrometry (MRM/MS). Changes in plasma proteome were
evaluated in relation to metabolic and inflammatory changes. RESULTS: BPD
resulted in improved insulin sensitivity and reduced body weight.
Proteomic analysis identified 29 proteins changed following BPD. Changes
in plasma levels of afamin, apolipoprotein A-IV (ApoA4) and apolipoprotein
A-II (ApoA2) correlated significantly with changes in IR. CONCLUSION:
Circulating levels of afamin, ApoA4 and ApoA2 were associated with and may
contribute to the rapid improvement in insulin sensitivity after BPD.