Tissue-specific methylation profile in obese patients with type 2 diabetes before and after Roux-en-Y gastric bypass

Author(s)

Sala, Priscila ; Matos de Miranda Torrinhas, Raquel Susana ; Fonseca, Danielle Cristina ; Ravacci, Graziela Rosa ; Waitzberg, Dan Linetzky ; Giannella-Neto, Daniel

• Document type: Review article
• Source: DIABETOLOGY & METABOLIC SYNDROME; v. 9, FEB 22 2017.
• Web of Science Citations: 11

Abstract

Eating habits, lifestyles, and exposure to specific environmental factors can greatly impact the risk of developing type 2 diabetes (T2D), influence the genome epigenetically, and affect the expression of genes, including genes related to glycemic control, at any stage of life. The epigenetic mechanism underlying obesity and T2D pathogenesis remains poorly understood. Conventional strategies for the treatment of obesity and its comorbidities often have poor longterm adherence, and pharmacological interventions are limited. Bariatric surgery is the most effective current option to treat severe obesity, and Roux-en-Y gastric bypass (RYGB) is the most applied technique worldwide. Epigenetic changes differ depending on the approach used to treat obesity and its associated comorbidities (clinical or surgical). Compared to primary clinical care, bariatric surgery leads to much greater loss of body weight and higher remission rates of T2D and metabolic syndrome, with methylation profiles in promoter regions of genes in obese individuals becoming similar to those of normal-weight individuals. Bariatric surgery can influence DNA methylation in parallel with changes in gene expression pattern. Changes in clinical biomarkers that reflect improvements in glucose and lipid metabolism after RYGB often occur before major weight loss and are coordinated by surgery-induced changes in intestinal hormones. Therefore, the intestine methylation profile would assist in understanding the mechanisms involved in improved glycemic control after bariatric surgery. The main objectives in this area for the future are to identify epigenetic marks that could be used as early indicators of metabolic risk, and to develop treatments able to delay or even reverse these epigenetic changes. Studies that provide the ``human epigenetic profile{''} will be of considerable value to identify tissue-specific epigenetic signatures and their role in the development of chronic diseases. Further studies should apply methods based on global analysis of the genome to identify methylated sites associated with disease and epigenetic marks associated with the remodeling response to bariatric surgery. This review describes the main epigenetic alterations associated with obesity and T2D and the potential role of RYGB in remodeling these changes. (AU)

• FAPESP's process: 13/03246-0 - Genomic, proteomic and metabolomic study of gastrointestinal tissue for patients with type 2 Diabetes mellitus after Roux-en-Y gastric bypass
• Grantee: Priscila Sala Kobal
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 11/09612-3 - Changes in gene expression in gastric and intestinal tissue of type 2 Diabetes patients submitted to Roux-en-Y gastric bypass
• Grantee: Dan Linetzky Waitzberg
• Support Opportunities: Research Projects - Thematic Grants