From adipokine to integrator: longitudinal galectin-1 changes mirror glycemic, hepatic, renal, and lipid remodeling after bariatric surgery.

Abstract

Background: Circulating galectin-1 levels increase with adiposity, and experimental data implicate this adipokine in the development of metabolic dysfunction. However, its longitudinal trajectory and organ-specific associations during weight loss remain poorly defined.

Methods: In this prospective study, we enrolled 117 adults with severe obesity, with a mean body mass index (BMI) 40.3 ± 5.3 kg/m², undergoing sleeve gastrectomy. Circulating galectin-1 levels and comprehensive metabolic profiles were assessed preoperatively and one year after surgery.

Results: Participants achieved a mean total weight loss of 32.2 ± 7.8%, accompanied by significant improvements in blood pressure, glycemic control, liver enzymes, and lipid profiles. Baseline galectin-1 concentrations did not differ between participants with and without type 2 diabetes and were not associated with diabetes remission at one year. Galectin-1 levels significantly decreased from 13.2 ± 5.8 to 11.0 ± 6.5 pg/mL (p < 0.001). The percentage reduction in galectin-1 was significantly correlated with improvements in aspartate aminotransferase (AST), alanine transaminase (ALT), creatinine, total cholesterol, and low-density lipoprotein (LDL) cholesterol, but not with glycemic indices. In multivariable stepwise regression, baseline galectin-1 was independently associated with BMI, creatinine, and estimated glomerular filtration rate (eGFR). One year postoperatively, galectin-1 remained independently associated with glycated hemoglobin (A1c), quantitative insulin sensitivity check index (QUICKI), AST, ALT, creatinine, and high-density lipoprotein (HDL) cholesterol.

Conclusions: Galectin-1 levels declined after weight loss and exhibited distinct associations with multiple metabolic systems. These results position galectin-1 as a potential integrative biomarker that mirrors glycemic, hepatic, renal, and lipid remodeling in response to bariatric surgery.