Abstract
Severe obese patients with type 2 diabetes mellitus (T2DM) submitted to Roux-en-Y gastric bypass (RYGB) show significant improvement in glucose control after surgery upon discharge from the hospital, even before a considerable weight loss, with suppression of hypoglycemic drugs. Experimentally, the anatomical changes induced by RYGB can change genes expression in gastrointestinal tissue related to glucose control determinants to T2DM reversal. However, there aren't clinical studies that prove these findings in humans. We will study 20 severely obese patients with T2DM candidates for RYGB. Before and 3 months after surgery, biopsies will be collected from the gastric body, gastric fundus, duodenum, jejunum and ileum by double balloon enteroscopy, used to verify changes in mRNA expression by microarray technique. Altered gene expressed will be validated by RT-qPCR and protein expression by mass spectrometry. The plasma glucose, incretins, insulin, C-peptide and glycosylated hemoglobin will also be evaluated before and after surgery. Metabolic pathways involving genes reportedly regulated after RYGB will be identified and proposed as a potential therapeutic target for T2DM. The composition of intestinal microbiota in obese patients with T2DM has been suggested as key element in glucose control. Accordingly, in parallel, we evaluate the preoperative and postoperative changes in the composition of fecal microbiota in our patients. (AU)
Scientific publications
(14)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CARDINELLI, CAMILA DE SIQUEIRA;
TORRINHAS, RAQUEL SUSANA;
SALA, PRISCILA;
PUDENZI, MARCOS ALBIERI;
ANGOLINI, CELIO FERNANDO F.;
DA SILVA, MARIANE MARQUES;
MACHADO, NATASHA MENDONCA;
RAVACCI, GRAZIELA;
EBERLIN, MARCOS N.;
WAITZBERG, DAN L.
Fecal bile acid profile after Roux-en-Y gastric bypass and its association with the remission of type 2 diabetes in obese women: A preliminary study.
Clinical Nutrition,
v. 38,
n. 6,
p. 2906-2912,
DEC 2019.
Web of Science Citations: 1.
GARLA, PRISCILA;
SALA, PRISCILA;
MATOS TORRINHAS, RAQUEL SUSANA;
MACHADO, NATASHA MENDONCA;
FONSECA, DANIELLE CRISTINA;
DA SILVA, MARIANE MARQUES;
RAVACCI, GRAZIELA ROSA;
BELARMINO, GILIANE;
ISHIDA, ROBSON KIYOSHI;
MOTA SIQUEIRA GUARDA, ISMAEL FRANCISCO;
HOURNEAUX DE MOURA, EDUARDO GUIMARDES;
SAKAI, PAULO;
SANTO, MARCO AURELIO;
COTRIM GUERREIRO DA SILVA, ISMAEL DALE;
ALVES PEREIRA, CLAUDIA CRISTINA;
HEYMSFIELD, STEVEN;
CARDILLO CORREA-GIANNELLA, MARIA LUCIA;
CALDER, PHILIP C.;
WAITZBERG, DAN LINETZKY.
Reduced intestinal FADS1 gene expression and plasma omega-3 fatty acids following Roux-en-Y gastric bypass.
Clinical Nutrition,
v. 38,
n. 3,
p. 1280-1288,
JUN 2019.
Web of Science Citations: 0.
RAVACCI, GRAZIELA ROSA;
ISHIDA, ROBSON;
TORRINHAS, RAQUEL SUZANA;
SALA, PRISCILA;
MACHADO, NATASHA MENDONCA;
FONSECA, DANIELLE CRISTINA;
BAPTISTA CANUTO, GISELE ANDRE;
PINTO, ERNANI;
NASCIMENTO, VIVIANE;
MAGGI TAVARES, MARINA FRANCO;
SAKAI, PAULO;
FAINTUCH, JOEL;
SANTO, MARCO AURELIO;
HOURNEAUX MOURA, EDUARDO GUIMARAES;
ARTIGIANI NETO, RICARDO;
LOGULLO, ANGELA FLAVIA;
WAITZBERG, DAN LINETZKY.
Potential premalignant status of gastric portion excluded after Roux en-Y gastric bypass in obese women: A pilot study.
SCIENTIFIC REPORTS,
v. 9,
APR 3 2019.
Web of Science Citations: 0.
FONSECA, DANIELLE CRISTINA;
SALA, PRISCILA;
SINGER, JOELLE;
SINGER, PIERRE;
TORRINHAS, RAQUEL SUSANA;
WAITZBERG, DAN LINETZKY.
Upregulation of Ghrelin Gene Expression in the Excluded Stomach of Obese Women with Type 2 Diabetes After Roux-en-Y Gastric Bypass in the SURMetaGIT Study.
OBESITY SURGERY,
v. 28,
n. 3,
p. 877-880,
MAR 2018.
Web of Science Citations: 3.
SALA, PRISCILA;
TORRINHAS, RAQUEL SUSANA;
FONSECA, DANIELLE CRISTINA;
HEYMSFIELD, STEVEN;
GIANNELLA-NETO, DANIEL;
WAITZBERG, DAN LINETZKY.
Type 2 Diabetes Remission After Roux-en-Y Gastric Bypass: Evidence for Increased Expression of Jejunal Genes Encoding Regenerating Pancreatic Islet-Derived Proteins as a Potential Mechanism.
OBESITY SURGERY,
v. 27,
n. 4,
p. 1123-1127,
APR 2017.
Web of Science Citations: 8.
SALA, PRISCILA;
BELARMINO, GILIANE;
TORRINHAS, RAQUEL S.;
MACHADO, NATASHA M.;
FONSECA, DANIELLE C.;
RAVACCI, GRAZIELA R.;
ISHIDA, ROBSON K.;
GUARDA, ISMAEL F. M. S.;
DE MOURA, EDUARDO G.;
SAKAI, PAULO;
SANTO, MARCO A.;
DA SILVA, ISMAEL D. C. G.;
PEREIRA, CLAUDIA C. A.;
LOGULLO, ANGELA F.;
HEYMSFIELD, STEVEN;
GIANNELLA-NETO, DANIEL;
WAITZBERG, DAN L.
Gastrointestinal Transcriptomic Response of Metabolic Vitamin B12 Pathways in Roux-en-Y Gastric Bypass.
CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY,
v. 8,
JAN 2017.
Web of Science Citations: 5.
SALA, PRISCILA;
BELARMINO, GILIANE;
MACHADO, NATASHA MENDONCA;
CARDINELLI, CAMILA SIQUEIRA;
AL ASSAL, KARINA;
SILVA, MARIANE MARQUES;
FONSECA, DANIELLE CRISTINA;
ISHIDA, ROBSON KIYOSHI;
SANTO, MARCO AURELIO;
HOURNEAUX DE MOURA, EDUARDO GUIMARAES;
SAKAI, PAULO;
MOTA SIQUEIRA GUARDA, ISMAEL FRANCISCO;
COTRIM GUERREIRO DA SILVA, ISMAEL DALE;
RODRIGUES, AGATHA SACRAMENTO;
DE BRAGANCA PEREIRA, CARLOS ALBERTO;
HEYMSFIELD, STEVEN;
DORE, JOEL;
MATOS DE MIRANDA TORRINHAS, RAQUEL SUSANA;
GIANNELLA-NETO, DANIEL;
WAITZBERG, DAN LINETZKY.
The SURMetaGIT study: Design and rationale for a prospective pan-omics examination of the gastrointestinal response to Roux-en-Y gastric bypass surgery.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH,
v. 44,
n. 6,
p. 1359-1375,
DEC 2016.
Web of Science Citations: 4.