Departamento de Gastroenterologia, Laboratório Metanutri (LIM 35), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Departamento de Gastroenterologia, Laboratório Metanutri (LIM 35), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Clin Nutr. 2019 Jun;38(3):1280-1288. doi: 10.1016/j.clnu.2018.05.011. Epub 2018 May 29.
BACKGROUND & AIMS: Roux-en-Y gastric bypass (RYGB) limits food ingestion and may alter the intestinal expression of genes involved in the endogenous synthesis of polyunsaturated fatty acids (PUFAs). These changes may decrease the systemic availability of bioactive PUFAs after RYGB. To study the impact of RYGB on the dietary ingestion and plasma concentration of PUFAs and on the intestinal expression of genes involved in their endogenous biosynthesis in severely obese women with type 2 diabetes.
Before, and 3 and 12 months after RYGB, obese women (n = 20) self-reported a seven-day dietary record, answered a food frequency query and provided plasma samples for alpha-linolenic (ALA), eicosapentaenoic (EPA), docosahexaenoic (DHA) and arachidonic (ARA) acid assessment by gas chromatography. Intestinal biopsies (duodenum, jejunum and ileum) were collected through double-balloon endoscopy before and 3 months after RYGB for gene expression analysis by microarray (Human GeneChip 1.0 ST array) and RT-qPCR validation.
Compared to the preoperative period, patients had decreased intakes of PUFAs, fish and soybean oil (p < 0.05) and lower plasma concentrations of ALA and EPA (p < 0.001) 3 and 12 months after RYGB. FADS1 gene expression was lower in duodenum (RT-qPCR fold change = -1.620, p < 0.05) and jejunum (RT-qPCR fold change = -1.549, p < 0.05) 3 months following RYGB, compared to before surgery.
RYGB decreased PUFA ingestion, plasma ALA and EPA levels, and intestinal expression of FADS1 gene. The latter encodes a key enzyme involved in endogenous biosynthesis of PUFAs. These data suggest that supplementation of omega-3 PUFAs may be required for obese patients undergoing RYGB. Clinical Trial Registry number and website: www.clinicaltrials.gov - NCT01251016; Plataforma Brasil - 19339913.0.0000.0068.
Roux-en-Y 胃旁路术(RYGB)限制食物摄入,并可能改变参与内源性多不饱和脂肪酸(PUFAs)合成的肠道基因表达。这些变化可能会降低 RYGB 后生物活性 PUFAs 的系统可用性。本研究旨在探讨 RYGB 对 2 型糖尿病肥胖女性饮食摄入和血浆 PUFAs 浓度以及肠道内源性生物合成相关基因表达的影响。
在 RYGB 术前、术后 3 个月和 12 个月,肥胖女性(n=20)自我报告了为期 7 天的饮食记录,回答了食物频率查询,并提供了血浆样本,通过气相色谱法评估α-亚麻酸(ALA)、二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)和花生四烯酸(ARA)的含量。通过双气囊内镜在 RYGB 术前和术后 3 个月采集十二指肠、空肠和回肠的肠道活检样本,通过微阵列(Human GeneChip 1.0 ST array)进行基因表达分析,并通过 RT-qPCR 进行验证。
与术前相比,患者在 RYGB 术后 3 个月和 12 个月时 PUFAs、鱼类和大豆油的摄入量减少(p<0.05),血浆 ALA 和 EPA 浓度降低(p<0.001)。RYGB 术后 3 个月,FADS1 基因在十二指肠(RT-qPCR 倍数变化=-1.620,p<0.05)和空肠(RT-qPCR 倍数变化=-1.549,p<0.05)的表达降低。
RYGB 减少了 PUFAs 的摄入、血浆 ALA 和 EPA 水平以及 FADS1 基因的肠道表达。后者编码参与内源性 PUFAs 合成的关键酶。这些数据表明,接受 RYGB 的肥胖患者可能需要补充ω-3 PUFAs。临床试验注册号和网站:www.clinicaltrials.gov - NCT01251016;Plataforma Brasil - 19339913.0.0000.0068。