Metabolomic fingerprint of severe obesity is dynamically affected by bariatric surgery in a procedure-dependent manner

Nov 20, 2015The American journal of clinical nutrition

Severe obesity's metabolic profile changes after weight-loss surgery depending on the type of procedure

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Abstract

Bariatric surgery is associated with distinct metabolomic changes in obese subjects, creating unique metabolic profiles compared to normal-weight individuals.

A metabolomic fingerprint in obese subjects is distinguishable from that of normal-weight individuals.
Bariatric procedures, including sleeve gastrectomy and Roux-en-Y gastric bypass, induce dynamic changes in the metabolomic profile specific to each procedure.
Key metabolites elevated in severe obesity include aromatic and branched-chain amino acids, as well as metabolites related to energy metabolism.
Post-surgery, new metabolomic fingerprints emerge that differ from those of BMI-matched controls and normal-weight subjects.
The findings suggest significant alterations in gut microbiome-host interactions following bariatric surgery.

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BACKGROUND: Obesity is associated with multiple diseases. Bariatric surgery is the most effective therapy for severe obesity that can reduce body weight and obesity-associated morbidity. The metabolic alterations associated with obesity and respective changes after bariatric surgery are incompletely understood.

OBJECTIVE: We comprehensively assessed metabolic alterations associated with severe obesity and distinct bariatric procedures.

DESIGN: In our longitudinal observational study, we applied a (1)H-nuclear magnetic resonance-based global, untargeted metabolomics strategy on human serum samples that were collected before and repeatedly ≤1 y after distinct bariatric procedures [i.e., a sleeve gastrectomy, proximal Roux-en Y gastric bypass (RYGB), and distal RYGB]. For comparison, we also analyzed serum samples from normal-weight and less-obese subjects who were matched for 1-y postoperative body mass index (BMI) values of the surgical groups.

RESULTS: We identified a metabolomic fingerprint in obese subjects that was clearly discriminated from that of normal-weight subjects. Furthermore, we showed that bariatric surgery (sleeve gastrectomy and proximal and distal RYGB) dynamically affected this fingerprint in a procedure-dependent manner, thereby establishing new fingerprints that could be discriminated from those of BMI-matched and normal-weight control subjects. Metabolites that largely contributed to the metabolomic fingerprints of severe obesity were aromatic and branched-chain amino acids (elevated), metabolites related to energy metabolism (pyruvate and citrate; elevated), and metabolites suggested to be derived from gut microbiota (formate, methanol, and isopropanol; all elevated).

CONCLUSION: Our data indicate that bariatric surgery, irrespective of the specific kind of procedure used, reverses most of the metabolic alterations associated with obesity and suggest profound changes in gut microbiome-host interactions after the surgery. This trial was registered at clinicaltrials.gov as NCT02480322.

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Metabolomic fingerprint of severe obesity is dynamically affected by bariatric surgery in a procedure-dependent manner

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