Short-term changes in the serum metabolome after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

Aug 6, 2021Metabolomics : Official journal of the Metabolomic Society

Short-term changes in blood metabolites after two types of weight-loss surgery

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Abstract

Serum metabolites related to amino acids and lipids changed after laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), with greater changes observed in SG.

Changes in metabolites are associated with lowered risk factors for obesity-related diseases, including nonalcoholic fatty liver disease, type 2 diabetes, and atherosclerosis.
A greater number of significantly altered metabolites related to lipid metabolism were observed in patients who underwent SG compared to those who had RYGB.
Significant changes in metabolites related to amino acid metabolism occurred only after SG, while bile acids changed significantly only following RYGB.
Differences in metabolite changes may result from the anatomical differences between the two surgical procedures.
The findings could be related to variations in gut microbiota influenced by each bariatric procedure.

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INTRODUCTION: Bariatric surgery is known to be the most effective treatment for weight loss in obese patients and for the rapid remission of obesity-related comorbidities. These short-term improvements result from not only limited digestion or absorption but also dynamic changes in metabolism throughout the whole body. However, short-term metabolism studies associated with bariatric surgery in Asian individuals have not been reported.

OBJECTIVES: The aim of this study was to investigate the short-term metabolome changes in the serum promoted by laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) and to determine the underlying mechanisms that affect obesity-related comorbidities.

METHODS: Serum samples were collected from Korean patients who underwent RYGB or SG before and 4 weeks after the surgery. Metabolomic and lipidomic profiling was performed using UPLC-Orbitrap-MS, and data were analyzed using statistical analysis.

RESULTS: Metabolites mainly related to amino acids, lipids (fatty acids, glycerophospholipids, sphingolipids, glycerolipids) and bile acids changed after surgery, and these changes were associated with the lowering of risk factors for obesity-related diseases such as nonalcoholic fatty liver disease (NAFLD), type 2 diabetes (T2D) and atherosclerosis. Interestingly, the number of significantly altered metabolites related to the lipid metabolism were greater in SG than in RYGB. Furthermore, the metabolites related to amino acid metabolism were significantly changed only after SG, whereas bile acid changed significantly only following RYGB.

CONCLUSION: These differences could result from anatomical differences between the two surgeries and could be related to the gut microbiota. This study provides crucial information to expand the knowledge of the common but different molecular mechanisms involved in obesity and obesity-related comorbidities affected by each bariatric procedure.

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Short-term changes in the serum metabolome after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

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