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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Type 2 Diabetes Metabolic Improvement After Roux-en-Y Gastric Bypass May Include a Compensatory Mechanism That Balances Fatty Acid beta and omega Oxidation

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Author(s):
Machado, Natasha Mendonca [1] ; Torrinhas, Raquel Susana [1] ; Sala, Priscila [1] ; Ishida, Robson Kiyoshi [2] ; Mota Siqueira Guarda, Ismael Francisco [2] ; Hourneaux de Moura, Eduardo Guimaraes [2] ; Sakai, Paulo [2] ; Santo, Marco Aurelio [3] ; Waitzberg, Dan Linetzky [1]
Total Authors: 9
Affiliation:
[1] Univ Sao Paulo, Dept Gastroenterol, Fac Med, Sao Paulo, SP - Brazil
[2] Univ Sao Paulo, Hosp Clin, Dept Gastroenterol, Gastrointestinal Endoscopy Unit, Fac Med, Sao Paulo, SP - Brazil
[3] Univ Sao Paulo, Hosp Clin, Bariatr & Metab Surg Unit, Fac Med, Sao Paulo, SP - Brazil
Total Affiliations: 3
Document type: Journal article
Source: Journal of Parenteral and Enteral Nutrition; v. 44, n. 8 JUL 2020.
Web of Science Citations: 0
Abstract

Background More than half of patients who undergo Roux-en-Y gastric bypass (RYGB) can experience type 2 diabetes (T2D) remission, but the systemic and gastrointestinal (GI) metabolic mechanisms of this improvement are still elusive. Methods Paired samples collected before and 3 months after RYGB from 28 women with obesity and T2D were analyzed by metabolomics with gas chromatography coupled to mass spectrometry. Samples include plasma (n = 56) and biopsies of gastric pouch (n = 18), gastric remnant (n = 10), duodenum (n = 16), jejunum (n = 18), and ileum (n = 18), collected by double-balloon enteroscopy. Results After RYGB, improvements in body composition and weight-related and glucose homeostasis parameters were observed. Plasma-enriched metabolic pathways included arginine and proline metabolism, urea and tricarboxylic acid (TCA) cycles, gluconeogenesis, malate-aspartate shuttle, and carnitine synthesis. In GI tissue, we observed alterations of ammonia recycling and carnitine synthesis in gastric pouch, phenylacetate metabolism and trehalose degradation in duodenum and jejunum, ketone bodies in jejunum, and lactose degradation in ileum. Intermediates molecules of the TCA cycle were enriched, particularly in plasma, jejunum, and ileum. Fluctuations of dicarboxylic acids (DCAs) were relevant in several metabolomic tests, and metabolite alterations included aminomalonate and fumaric, malic, oxalic, and succinic acids. The product/substrate relationship between these molecules and its pathways may reflect a compensatory mechanism to balance metabolism. Conclusions RYGB was associated with systemic and GI metabolic reprogramming. DCA alterations link omega and beta fatty acid oxidation to homeostatic mechanisms, including TCA cycle improvement. (AU)

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: 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: 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