The impact of bariatric and metabolic surgery on the levels of circulating growth differentiation factor 15 in humans

Obesity is a known risk factor cardiovascular disease, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH), characterized by a state of chronic inflammation. In this stress context, many hepatokines and adipokines may be released, including Growth Differentiation Factor 15 (GDF15). GDF15 is involved in the regulation of appetite and metabolism, showing potential for the treatment of obesity and related comorbidities. This review aimed to evaluate the impact of bariatric and metabolic surgery (BMS) in the levels of circulating GDF15 in individuals with obesity. Considering the studies available, reporting GDF15 levels before and 12 months after BMS, the profile of GDF15 changes was not a consensus, and was not fully explained by differences in the characterization of the population in each study. This review also discusses the multiple sources of GDF15 in obesity and in response to its surgical treatment, where pathological, pharmacological, and behavioral factors may all be important contributors.