Different Malabsorptive Obesity Surgery Interventions Result in Distinct Postprandial Amino Acid Metabolomic Signatures
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Different Malabsorptive Obesity Surgery Interventions Result in Distinct Postprandial Amino Acid Metabolomic Signatures. / Pereira, Sofia S.; Jarak, Ivana; Carvalho, Rui A.; Oliveira, Pedro F.; Alves, Marco G.; Guimaraes, Marta; Almeida, Rui; Pereira, Ana M.; Wewer Albrechtsen, Nicolai J.; Holst, Jens J.; Nora, Mario; Monteiro, Mariana P.
In: Obesity Surgery, Vol. 30, 2020, p. 4019-4028.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Different Malabsorptive Obesity Surgery Interventions Result in Distinct Postprandial Amino Acid Metabolomic Signatures
AU - Pereira, Sofia S.
AU - Jarak, Ivana
AU - Carvalho, Rui A.
AU - Oliveira, Pedro F.
AU - Alves, Marco G.
AU - Guimaraes, Marta
AU - Almeida, Rui
AU - Pereira, Ana M.
AU - Wewer Albrechtsen, Nicolai J.
AU - Holst, Jens J.
AU - Nora, Mario
AU - Monteiro, Mariana P.
PY - 2020
Y1 - 2020
N2 - Purpose Biliopancreatic diversion with duodenal switch (BPD-DS) is an effective weight loss surgical procedure. Yet, BPD-DS is technically difficult to perform and carries a higher risk of nutrient deficiencies as compared with other surgical interventions. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a modified BPD-DS procedure conceived with the aim of decreasing the technical complexity, while retaining the weight loss efficiency. Whether the two surgical procedures diverge in nutrient absorption rates and malnutrition risk is still matter of debate. Our aim was to determine if postprandial nutrient absorption rates are different in patients subjected to BPD-DS or SADI-S for weight loss. Materials and Methods Plasma amino acid metabolomic profiling during mixed-meal tolerance test (MMTT) was performed in subjects (N = 18) submitted to BPD-DS (n = 9) or SADI-S (n = 9) 1.6 +/- 0.1 years earlier. Results Patients submitted to SADI-S or BPD-DS presented distinct postprandial metabolomic profiles. Postprandial excursions of total and essential amino acids-leucine, isoleucine, and valine-were higher after SADI-S as compared with BPD-DS. Conclusion Our study demonstrates that a simplified malabsorptive bariatric surgery procedure SADI-S results in greater essential branched-chain amino acid absorption when compared with the classical BPD-DS intervention. These findings suggest that SADI-S can potentially lower lifetime risk of postoperative protein malnutrition, as well as have a positive impact on systemic metabolism and glucose homeostasis.
AB - Purpose Biliopancreatic diversion with duodenal switch (BPD-DS) is an effective weight loss surgical procedure. Yet, BPD-DS is technically difficult to perform and carries a higher risk of nutrient deficiencies as compared with other surgical interventions. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a modified BPD-DS procedure conceived with the aim of decreasing the technical complexity, while retaining the weight loss efficiency. Whether the two surgical procedures diverge in nutrient absorption rates and malnutrition risk is still matter of debate. Our aim was to determine if postprandial nutrient absorption rates are different in patients subjected to BPD-DS or SADI-S for weight loss. Materials and Methods Plasma amino acid metabolomic profiling during mixed-meal tolerance test (MMTT) was performed in subjects (N = 18) submitted to BPD-DS (n = 9) or SADI-S (n = 9) 1.6 +/- 0.1 years earlier. Results Patients submitted to SADI-S or BPD-DS presented distinct postprandial metabolomic profiles. Postprandial excursions of total and essential amino acids-leucine, isoleucine, and valine-were higher after SADI-S as compared with BPD-DS. Conclusion Our study demonstrates that a simplified malabsorptive bariatric surgery procedure SADI-S results in greater essential branched-chain amino acid absorption when compared with the classical BPD-DS intervention. These findings suggest that SADI-S can potentially lower lifetime risk of postoperative protein malnutrition, as well as have a positive impact on systemic metabolism and glucose homeostasis.
KW - Malabsorptive bariatric surgeries
KW - BPD-DS
KW - SADI-S
KW - Metabolomics
KW - Amino acid absorption
U2 - 10.1007/s11695-020-04774-z
DO - 10.1007/s11695-020-04774-z
M3 - Journal article
C2 - 32564307
VL - 30
SP - 4019
EP - 4028
JO - Obesity Surgery
JF - Obesity Surgery
SN - 0960-8923
ER -
ID: 244327690