Cholecystectomy - a potential selection bias in studies assessing the metabolic effects of bariatric surgeries

Author(s)

Machado, Natasha Mendonca ^[1] ; Cardinelli, Camila de Siqueira ^[1] ; Shen, Tong ^[2] ; Santo, Marco Aurelio ^[3] ; Torrinhas, Raquel Susana ^[1] ; Waitzberg, Dan Linetzky ^{[3, 1]}

Affiliation

^[1] Univ Sao Paulo, Dept Gastroenterol, Lab Nutr & Metab Surg Digest Tract LIM 35, Fac Med FMUSP, Sao Paulo, SP - Brazil

^[2] Univ Calif Davis, West Coast Metabol Ctr, Davis, CA 95616 - USA

^[3] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Digest Surg Dept, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: SCIENTIFIC REPORTS; v. 10, n. 1 JUN 30 2020.
• Web of Science Citations: 0

Abstract

Bile acids (BAs) are key mediators of the glycemic control after bariatric surgeries. Cholecystectomy modifies the kinetics of BAs, and whether this procedure influences the BAs pool and its metabolic response to bariatric surgeries is not known. We used targeted and untargeted metabolomics to assess whether cholecystectomy influenced plasma and fecal BAs fluctuations and the systemic metabolomic profile after Roux-en-Y gastric bypass (RYGB). Women with obesity and type 2 diabetes were included. Sample collections and clinical evaluations were performed before and 3 months after RYGB. RYGB influenced 9 fecal and 3 plasma BAs in patients with cholecystectomy (p <= 0.05). Comparisons between patients with and without cholecystectomy revealed different concentrations of 4 fecal and 5 plasma BAs (p <= 0.05). Cholecystectomy impacted the global metabolomics responses to RYGB, and patients who underwent the gallbladder removal also lacked some significant improvements in clinical markers, primarily the lipid profile. By affecting the BAs concentrations, cholecystectomy seems to alter the systemic metabolic response to RYGB. Therefore, cholecystectomy may act as a bias in assessments of the metabolic effects of bariatric surgeries and their relationships with clinical outcomes. (AU)

• FAPESP's process: 16/01259-6 - Metabolomic profile of patients with type 2 diabetes and obesity after Roux en Y gastric bypass
• Grantee: Natasha Mendonça Machado
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 13/23355-9 - Metabolomics profile of patients with type 2 diabetes and obesity after Roux en Y gastric bypass
• Grantee: Natasha Mendonça Machado
• Support Opportunities: Scholarships in Brazil - Doctorate
• 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
• FAPESP's process: 14/05220-1 - Metabolomics of fecal water in obese patients with Type 2 Diabetes before and after gastroplasty reduction in Y-Roux (GRYR)
• Grantee: Camila de Siqueira Cardinelli
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)