Li Shuqi, Shi Chenye, Wu Haifu, Yan Hongmei, Xia Mingfeng, Jiao Heng, He Yang, Zhong Ming, Lou Wenhui, Gao Xin, Bian Hua, Chang Xinxia
Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Endocr Connect. 2024 Oct 29;13(11). doi: 10.1530/EC-24-0292. Print 2024 Nov 1.
Bariatric surgery induces significant weight loss, increases insulin sensitivity, and improves dyslipidemia. As one of the most widely performed bariatric surgeries, laparoscopic sleeve gastrectomy (LSG) is thought to improve the metabolic profile along with weight loss. The objective of this study was to evaluate longitudinal changes in the serum metabolite levels after LSG and elucidate the underlying mechanisms of metabolic improvement.
Clinical metabolic parameters and serum samples were collected preoperatively and at 1, 3, and 6 months postoperatively from nine patients with obesity undergoing LSG. Serum metabolites were measured using a non-targeted metabolic liquid chromatography-mass spectrometry method.
During the 1, 3, and 6 months postoperative follow-up, the body mass index, HOMA-IR, and liver fat content showed a gradual descending trend. A total of 328 serum metabolites were detected, and 38 were differentially expressed. The up-regulated metabolites were mainly enriched in ketone body metabolism, alpha-linolenic acid and linoleic acid metabolism, pantothenate and CoA biosynthesis, glycerolipid metabolism, and fructose and mannose degradation, while the down-regulated metabolites were closely related to caffeine metabolism, oxidation of branched-chain fatty acids, glutamate metabolism, and homocysteine degradation. Notably, nine metabolites (oxoglutarate, 2-ketobutyric acid, succinic acid semialdehyde, phthalic acid, pantetheine, eicosapentaenoate, 3-hydroxybutanoate, oxamic acid, and dihydroxyfumarate) showed persistent differential expression at 1, 3, and 6 months follow-up. Some were found to be significantly associated with weight loss, insulin resistance improvement, and liver fat content reduction.
This finding may provide a new perspective for revealing novel biomarkers and mechanisms of metabolic improvement in obesity and related comorbidities.
减肥手术可显著减轻体重，提高胰岛素敏感性，并改善血脂异常。作为应用最广泛的减肥手术之一，腹腔镜袖状胃切除术（LSG）被认为在减轻体重的同时可改善代谢状况。本研究的目的是评估LSG术后血清代谢物水平的纵向变化，并阐明代谢改善的潜在机制。
收集9例接受LSG的肥胖患者术前及术后1、3、6个月的临床代谢参数和血清样本。采用非靶向代谢液相色谱-质谱法测定血清代谢物。
在术后1、3、6个月的随访中，体重指数、HOMA-IR和肝脏脂肪含量呈逐渐下降趋势。共检测到328种血清代谢物，其中38种差异表达。上调的代谢物主要富集于酮体代谢、α-亚麻酸和亚油酸代谢、泛酸和辅酶A生物合成、甘油olipid代谢以及果糖和甘露糖降解，而下调的代谢物则与咖啡因代谢、支链脂肪酸氧化、谷氨酸代谢和同型半胱氨酸降解密切相关。值得注意的是，9种代谢物（氧代戊二酸、2-酮丁酸、琥珀酸半醛、邻苯二甲酸、泛硫乙胺、二十碳五烯酸、3-羟基丁酸、草氨酸和二羟基富马酸）在随访1、3、6个月时持续差异表达。其中一些被发现与体重减轻、胰岛素抵抗改善和肝脏脂肪含量降低显著相关。
这一发现可能为揭示肥胖及相关合并症新的生物标志物和代谢改善机制提供新的视角。
