Ivana Jarak1, Sofia S Pereira2,3,4,5, Rui A Carvalho6, Pedro F Oliveira1,4,7, Marco G Alves1,7, Marta Guimarães2,3,8, Nicolai J Wewer Albrechtsen9,10,11, Jens J Holst9,10, Mário Nora8, Mariana P Monteiro12,13. 1. Biology and Genetics of Reproduction, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. 2. Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. 3. Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal. 4. Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal. 5. Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal. 6. Department of Life Sciences, Faculty of Science and Technology (FCTUC), University of Coimbra, Coimbra, Portugal. 7. Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal. 8. Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. 9. Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 10. Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2100, Copenhagen, Denmark. 11. Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark. 12. Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. mpmonteiro@icbas.up.pt. 13. Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal. mpmonteiro@icbas.up.pt.
Abstract
BACKGROUND/AIM: Roux-en-Y gastric bypass (RYGB) with a long biliopancreatic limb (BPL) was demonstrated to further improve type 2 diabetes (T2D) outcomes. Whether benefits occur at the cost of a negative impact on nutrient absorption is a matter of debate. Our aim was to evaluate the impact of RYGB BPL length on short-term nutrient absorption. METHODS: Subjects (N = 20) submitted to RYGB with a 2 m BPL (n = 11) or standard BPL (60-100 cm) (n = 9) 4.2 ± 0.4 years earlier underwent a mixed meal tolerance test. Plasma metabolites were analyzed at baseline and after meal by nuclear magnetic resonance (NMR) spectroscopy. Spectra were subject to multivariate analysis (MVA). Partial least square discriminant analysis (PLS-DA) was used to identify metabolites responsible for group discrimination. RESULTS: Principal component analysis and PLS-DA showed a clear separation between plasma metabolites before and 30 min after meal intake in both groups. The metabolites responsible for differences between time points were glucose and branched-chain amino acids. A complete overlap in metabolite species and concentrations was observed at 0 and 30 min time points for both groups, while acetate levels 120 min after the meal intake were significantly higher in subjects submitted to RYGB with a 2-m-long BPL as compared to the group submitted to the standard RYGB procedure. CONCLUSIONS: Post-prandial plasma metabolomics profiles suggest that a 2-m-long BLP RYGB does not have a negative impact on acute metabolite absorption. RYGB BPL length seems to influence post-prandial acetate levels, which could contribute to the additional positive metabolic outcomes.
BACKGROUND/AIM: Roux-en-Y gastric bypass (RYGB) with a long biliopancreatic limb (BPL) was demonstrated to further improve type 2 diabetes (T2D) outcomes. Whether benefits occur at the cost of a negative impact on nutrient absorption is a matter of debate. Our aim was to evaluate the impact of RYGB BPL length on short-term nutrient absorption. METHODS: Subjects (N = 20) submitted to RYGB with a 2 m BPL (n = 11) or standard BPL (60-100 cm) (n = 9) 4.2 ± 0.4 years earlier underwent a mixed meal tolerance test. Plasma metabolites were analyzed at baseline and after meal by nuclear magnetic resonance (NMR) spectroscopy. Spectra were subject to multivariate analysis (MVA). Partial least square discriminant analysis (PLS-DA) was used to identify metabolites responsible for group discrimination. RESULTS: Principal component analysis and PLS-DA showed a clear separation between plasma metabolites before and 30 min after meal intake in both groups. The metabolites responsible for differences between time points were glucose and branched-chain amino acids. A complete overlap in metabolite species and concentrations was observed at 0 and 30 min time points for both groups, while acetate levels 120 min after the meal intake were significantly higher in subjects submitted to RYGB with a 2-m-long BPL as compared to the group submitted to the standard RYGB procedure. CONCLUSIONS: Post-prandial plasma metabolomics profiles suggest that a 2-m-long BLP RYGB does not have a negative impact on acute metabolite absorption. RYGB BPL length seems to influence post-prandial acetate levels, which could contribute to the additional positive metabolic outcomes.
Authors: Patrick M Smith; Michael R Howitt; Nicolai Panikov; Monia Michaud; Carey Ann Gallini; Mohammad Bohlooly-Y; Jonathan N Glickman; Wendy S Garrett Journal: Science Date: 2013-07-04 Impact factor: 47.728