Department of Surgery & Cancer, Imperial College London, South Kensington, London, UK.
Australian National Phenome Centre & Centre for Computational & Systems Medicine, Health Futures Institute, Murdoch University, Perth, WA, Australia.
Sci Rep. 2022 Jan 7;12(1):294. doi: 10.1038/s41598-021-03833-4.
This study aims to explore the immediate effects of bariatric surgery on serum tryptophan-kynurenine pathway metabolites in individuals with type 2 diabetes and BMI > 30. With the goal of providing insight into the link between tryptophan pathway metabolites, type 2 diabetes, and chronic obesity-induced inflammation. This longitudinal study included 20 participants. Half were diagnosed with type 2 diabetes. 11 and 9 underwent RYGB and SG respectively. Blood samples were obtained at pre-operative and 3 months post-operative timepoints. Tryptophan and downstream metabolites of the kynurenine pathway were quantified with an ultrahigh-performance liquid chromatography tandem mass spectrometry with electrospray ionisation method. At 3 months post-operation, RYGB led to significant reductions in tryptophan, kynurenic acid and xanthurenic acid levels when compared to baseline. Significant reductions of the same metabolites after surgery were also observed in individuals with T2D irrespective of surgical procedure. These metabolites were significantly correlated with serum HbA1c levels and BMI. Bariatric surgery, in particular RYGB reduces serum levels of tryptophan and its downstream kynurenine metabolites. These metabolites are associated with T2D and thought to be potentially mechanistic in the systemic processes of obesity induced inflammation leading to insulin resistance. Its reduction after surgery is associated with an improvement in glycaemic control (HbA1c).
这项研究旨在探讨肥胖症手术对 2 型糖尿病和 BMI>30 的个体血清色氨酸-犬尿氨酸途径代谢物的即时影响。以期深入了解色氨酸途径代谢物、2 型糖尿病和慢性肥胖引起的炎症之间的联系。这项纵向研究纳入了 20 名参与者。其中一半被诊断患有 2 型糖尿病。11 名和 9 名参与者分别接受了 RYGB 和 SG。在术前和术后 3 个月采集血样。采用超高效液相色谱串联质谱法（电喷雾电离法）定量检测色氨酸和犬尿氨酸途径的下游代谢物。与基线相比，术后 3 个月时 RYGB 导致色氨酸、犬尿氨酸和黄尿酸水平显著降低。无论手术方式如何，T2D 患者手术后这些代谢物水平也显著降低。这些代谢物与血清 HbA1c 水平和 BMI 显著相关。肥胖症手术，特别是 RYGB，可降低血清色氨酸及其下游犬尿氨酸代谢物水平。这些代谢物与 2 型糖尿病相关，并且被认为在肥胖引起的炎症导致胰岛素抵抗的全身过程中具有潜在的机制作用。手术后其水平降低与血糖控制（HbA1c）改善相关。
