School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK.
Renal Transplant Unit, Manchester Royal Infirmary, Manchester, UK.
Sci Rep. 2022 Sep 12;12(1):15337. doi: 10.1038/s41598-022-19657-9.
Obesity is a complex disease that increases an individual's risk of developing other diseases and health-related problems. A common feature is dyslipidemia characterized by increased levels of plasma lipids, which include non-esterified fatty acids (NEFAs). The role of NEFAs in obesity-related morbidity is interesting as NEFAs constitute a reservoir of metabolic energy, are principal components of cell membranes and are precursors for signalling molecules. Bariatric surgery promotes sustained weight loss in severely obese patients, reducing the incidence and severity of co-morbidities. In this study we measure changes in circulating NEFA species in plasma samples taken from 25 obese individuals before and 9 months after Roux-en-Y gastric bypass surgery. The mean weight of the cohort reduced by 29.2% from 149.0 ± 25.1 kg pre-surgery to 105.5 ± 19.8 kg post-surgery and the BMI by 28.2% from 51.8 ± 6.3 kg/m pre-surgery to 37.2 ± 5.4 kg/m. Mean glycated haemoglobin (HbA1c) reduced from 6.5 ± 1.3 to 5.5 ± 0.5%, consistent with the intervention leading to improved glycaemic control, particularly in those who were dysglycemic prior to surgery. Total and LDL cholesterol concentrations were markedly reduced following surgery. Concentrations of seven NEFAs were found to decrease 9 months after surgery compared to pre-surgery levels: myristate, palmitoleate, palmitate, linoleate, oleate, stearate and arachidonate. Bariatric surgery led to increased lipogenesis and elongase activity and decreased stearoyl-CoA desaturase 1 activity. This study therefore highlights metabolic changes that take place following gastric bypass surgery in severely obese patients.
肥胖是一种复杂的疾病，会增加个体患其他疾病和健康相关问题的风险。一个常见的特征是血脂异常，其特征是血浆脂质水平升高，包括非酯化脂肪酸（NEFAs）。NEFAs 在肥胖相关发病机制中的作用很有趣，因为 NEFAs 构成代谢能量的储备，是细胞膜的主要成分，也是信号分子的前体。减重手术可促进严重肥胖患者持续减重，降低合并症的发生率和严重程度。在这项研究中，我们测量了 25 名肥胖个体在 Roux-en-Y 胃旁路手术后 9 个月前后的血浆样本中循环 NEFA 种类的变化。队列的平均体重从手术前的 149.0 ± 25.1kg 降至手术后的 105.5 ± 19.8kg，降幅为 29.2%，BMI 从手术前的 51.8 ± 6.3kg/m 降至 37.2 ± 5.4kg/m，降幅为 28.2%。糖化血红蛋白（HbA1c）均值从 6.5 ± 1.3%降至 5.5 ± 0.5%，表明干预措施改善了血糖控制，特别是在手术前血糖异常的患者中。手术后总胆固醇和 LDL 胆固醇浓度明显降低。手术后 9 个月发现七种 NEFA 的浓度较术前水平降低：豆蔻酸、棕榈油酸、棕榈酸、亚油酸、油酸、硬脂酸和花生四烯酸。减重手术后，脂肪生成和延长酶活性增加，硬脂酰辅酶 A 去饱和酶 1 活性降低。因此，这项研究强调了严重肥胖患者胃旁路手术后发生的代谢变化。
