Type 2 Diabetes Metabolic Improvement After Roux-e... - BV FAPESP
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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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Autor(es):
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]
Número total de Autores: 9
Afiliação do(s) autor(es):
[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
Número total de Afiliações: 3
Tipo de documento: Artigo Científico
Fonte: Journal of Parenteral and Enteral Nutrition; v. 44, n. 8 JUL 2020.
Citações Web of Science: 0
Resumo

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)

Processo FAPESP: 13/23355-9 - Análise do perfil metabolômico de pacientes obesos portadores de diabetes melito tipo 2 após gastroplastia redutora a y de roux
Beneficiário:Natasha Mendonça Machado
Modalidade de apoio: Bolsas no Brasil - Doutorado
Processo FAPESP: 16/01259-6 - Análise do perfil metabolômico de pacientes obesos portadores de diabetes melito tipo 2 após gastroplastia redutora a Y de Roux
Beneficiário:Natasha Mendonça Machado
Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado
Processo FAPESP: 11/09612-3 - Alterações na expressão gênica do tecido gástrico e intestinal de portadores de Diabetes melito tipo 2 submetidos à gastroplastia redutora a Y-Roux
Beneficiário:Dan Linetzky Waitzberg
Modalidade de apoio: Auxílio à Pesquisa - Temático