Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA.
Department of Surgery, University of Tennessee Medical Center Knoxville, TN, USA.
Diabetes Metab Res Rev. 2018 Nov;34(8):e3045. doi: 10.1002/dmrr.3045. Epub 2018 Sep 19.
Bariatric surgery induces significant weight loss, increases insulin sensitivity, and reduces mortality, but the underlying mechanisms are not clear. It was hypothesized that Roux-en-Y gastric bypass (RYGB) surgery improves metabolic profile along with weight loss. The objective of this pilot study was to evaluate changes in serum metabolites and fatty acids (FA) at 2 weeks and 6 months after RYGB.
Serum samples were collected pre-surgery, at 2 weeks and 6 months post-surgery from 20 patients undergoing RYGB surgery. Serum non-esterified free FA (NEFA) were measured. Serum metabolites and FA were measured using nuclear magnetic resonance spectroscopy and improved direct fatty acid methyl ester synthesis and the gas chromatography/mass spectrometry method, respectively, in subjects who completed follow-up at 6 months (n = 8).
Mean (standard deviation) percent total weight loss was 6.70% (1.7) and 24.91% (6.63) at 2 weeks (n = 15) and 6 months (n = 8) post-surgery, respectively. NEFA were significantly reduced at 6 months post-surgery (P = 0.001, n = 8). Serum branched chain amino acids, 2-aminobutyrate, butyrate, 2-hydroxybutyrate, 3-hydroxybutyrate, acetone, 2-methylglutarate, and 2-oxoisocaproate were significantly reduced, while serum alanine, glycine, pyruvate, and taurine were significantly elevated at 6 months post-surgery compared with pre-surgery (n = 8, P < 0.05). Also, serum FA C10:0, C13:0, C14:0, C15:0, and C18:0 increased significantly (n = 8, P < 0.05) by 6 months post-surgery.
Changes in serum metabolites and FA at 6 months post-RYGB surgery in this pilot study with limited number of participants are suggestive of metabolic improvement; larger studies are warranted for confirmation.
减重手术可显著减轻体重、增加胰岛素敏感性并降低死亡率，但具体机制尚不清楚。有研究假设 Roux-en-Y 胃旁路术（RYGB）可在减轻体重的同时改善代谢状况。本研究旨在评估 RYGB 术后 2 周和 6 个月时血清代谢物和脂肪酸（FA）的变化。
本研究纳入了 20 例行 RYGB 手术的患者，分别在术前、术后 2 周和 6 个月采集血清样本。测量非酯化游离脂肪酸（NEFA）。对完成 6 个月随访的 8 例患者采用核磁共振波谱法和改良直接脂肪酸甲酯合成气相色谱/质谱法分别测量血清代谢物和 FA。
术后 2 周和 6 个月的体重总降幅分别为 6.70%（1.7）和 24.91%（6.63）（n=15）。术后 6 个月时 NEFA 显著降低（P=0.001，n=8）。与术前相比，术后 6 个月时血清支链氨基酸、2-氨基丁酸、丁酸盐、2-羟丁酸、3-羟丁酸、丙酮、2-甲基戊二酸盐和 2-氧代异己酸盐显著降低，而血清丙氨酸、甘氨酸、丙酮酸和牛磺酸显著升高（n=8，P<0.05）。此外，术后 6 个月时血清 FA C10:0、C13:0、C14:0、C15:0 和 C18:0 显著增加（n=8，P<0.05）。
在本研究中，20 例参与者的 RYGB 术后 6 个月的血清代谢物和 FA 变化表明代谢改善，需要更大规模的研究来证实。
