Metabolite Changes After Metabolic Surgery – Associations to Parameters Reflecting Glucose Homeostasis and Lipid Levels

• Aims: To test the hypothesis that adipose tissue gene expression patterns would be affected by metabolic surgery and we aimed to identify genes and metabolic pathways as well as metabolites correlating with metabolic changes following metabolic surgery. Materials and Methods: This observational study was conducted at the Obesity Unit at the Catholic University Hospital of the Sacred Heart in Rome, Italy. Fifteen patients, of which six patients underwent Roux-en-Y gastric bypass and nine patients underwent biliopancreatic diversion, were included. The participants underwent an oral glucose tolerance test and a hyperinsulinemic euglycemic clamp. Small polar metabolites were analyzed with a two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC×GC-TOFMS). Gene expression analysis of genes related to metabolism of amino acids and fatty acids were analyzed in subcutaneous adipose tissue. All procedures were performed at study start and at follow-up (after 185.3 ± 72.9 days). Results: Twelve metabolites were significantly changed after metabolic surgery. Six metabolites were identified as 3-indoleacetic acid, 2-hydroxybutyric acid, valine, glutamic acid, 4-hydroxybenzeneacetic acid and alpha-tocopherol. The branched chain amino acids displayed a significant decrease together with a decrease in BCAT1 adipose tissue mRNA levels. Changes in the identified metabolites were associated to changes in lipid, insulin and glucose levels. Conclusions: Our study has identified metabolites and metabolic pathways that are altered by metabolic surgery and may be used as biomarkers for metabolic improvement. Copyright © 2021 Ahlin, Cefalo, Bondia-Pons, Trošt, Capristo, Marini, Romero, Zorzano, Gastaldelli, Mingrone and Nolan.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Cell- och molekylärbiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Cell and Molecular Biology (hsv//eng)

Nyckelord

adipose tissue

branched chain amino acids (BCAA)

metabolic pathway

metabolic surgery

metabolomics

2 hydroxybutyric acid

4 hydroxybenzeneacetic acid

acetyl coenzyme A carboxylase

adipophilin

alpha tocopherol

amino acid

aromatic amino acid

aspartate ammonia ligase

branched chain amino acid

C peptide

diacylglycerol acyltransferase 1

fatty acid

fatty acid synthase

glucose

glutamate dehydrogenase

glutamic acid

glycine amidinotransferase

hormone sensitive lipase

indoleacetic acid

lipid

messenger RNA

organic compound

perilipin 1

saturated fatty acid

unclassified drug

valine

adult

amino acid metabolism

Article

bariatric surgery

BCAT1 gene

BCAT2 gene

BCKDH alpha

BCKDH alpha gene

BCKDH beta gene

biliopancreatic bypass

blood sampling

body mass

clinical article

fatty acid metabolism

female

follow up

gene expression

gene expression profiling

glucose blood level

glucose homeostasis

homeostasis model assessment

human

hyperinsulinemic-euglycemic clamp technique

insulin release

insulin sensitivity

lipid level

male

mass fragmentography

metabolic parameters

metabolite

observational study

oral glucose tolerance test

real time polymerase chain reaction

RNA isolation

Roux-en-Y gastric bypass

time of flight mass spectrometry

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