Nutriomique U872 team 7, Institut National de la Santé et de la Recherche Médicale, Paris, France.
PLoS One. 2009 Nov 19;4(11):e7905. doi: 10.1371/journal.pone.0007905.
Roux-en-Y gastric bypass (RYGB) surgery is associated with weight loss, improved insulin sensitivity and glucose homeostasis, and a reduction in co-morbidities such as diabetes and coronary heart disease. To generate further insight into the numerous metabolic adaptations associated with RYGB surgery, we profiled serum metabolites before and after gastric bypass surgery and integrated metabolite changes with clinical data.
Serum metabolites were detected by gas and liquid chromatography-coupled mass spectrometry before, and 3 and 6 months after RYGB in morbidly obese female subjects (n = 14; BMI = 46.2+/-1.7). Subjects showed decreases in weight-related parameters and improvements in insulin sensitivity post surgery. The abundance of 48% (83 of 172) of the measured metabolites changed significantly within the first 3 months post RYGB (p<0.05), including sphingosines, unsaturated fatty acids, and branched chain amino acids. Dividing subjects into obese (n = 9) and obese/diabetic (n = 5) groups identified 8 metabolites that differed consistently at all time points and whose serum levels changed following RYGB: asparagine, lysophosphatidylcholine (C18:2), nervonic (C24:1) acid, p-Cresol sulfate, lactate, lycopene, glucose, and mannose. Changes in the aforementioned metabolites were integrated with clinical data for body mass index (BMI) and estimates for insulin resistance (HOMA-IR). Of these, nervonic acid was significantly and negatively correlated with HOMA-IR (p = 0.001, R = -0.55).
Global metabolite profiling in morbidly obese subjects after RYGB has provided new information regarding the considerable metabolic alterations associated with this surgical procedure. Integrating clinical measurements with metabolomics data is capable of identifying markers that reflect the metabolic adaptations following RYGB.
Roux-en-Y 胃旁路 (RYGB) 手术与体重减轻、胰岛素敏感性和葡萄糖稳态改善以及糖尿病和冠心病等合并症减少有关。为了更深入地了解与 RYGB 手术相关的众多代谢适应，我们在 RYGB 手术前后对血清代谢物进行了分析，并将代谢物变化与临床数据相结合。
我们对 14 名病态肥胖女性患者（BMI=46.2+/-1.7）在 RYGB 手术前、手术后 3 个月和 6 个月时进行了气相和液相色谱-质谱联用检测血清代谢物。手术后，患者的体重相关参数下降，胰岛素敏感性改善。在 RYGB 后前 3 个月内，有 48%（83/172）的测量代谢物的丰度发生了显著变化（p<0.05），包括神经鞘氨醇、不饱和脂肪酸和支链氨基酸。将患者分为肥胖组（n=9）和肥胖/糖尿病组（n=5），确定了 8 种在所有时间点均持续存在且血清水平随 RYGB 变化的代谢物：天冬酰胺、溶血磷脂酰胆碱（C18：2）、神经酸（C24：1）、对甲酚硫酸酯、乳酸、番茄红素、葡萄糖和甘露糖。将上述代谢物的变化与体重指数（BMI）和胰岛素抵抗估计值（HOMA-IR）的临床数据相结合。其中，神经酸与 HOMA-IR 呈显著负相关（p=0.001，R=-0.55）。
对 RYGB 后病态肥胖患者的全局代谢物谱进行分析，为该手术相关的显著代谢改变提供了新的信息。将临床测量值与代谢组学数据相结合，能够识别反映 RYGB 后代谢适应的标志物。
