Gakyung Lee1,2, Young Suk Park3, Chamlee Cho4, Hyunbeom Lee1, Jinyoung Park1, Do Joong Park3,5, Joo Ho Lee6, Hyuk-Joon Lee5, Tae Kyung Ha7, Yong-Jin Kim8,9, Seung-Wan Ryu10, Sang-Moon Han11,12, Moon-Won Yoo13, Sungsoo Park14, Sang-Uk Han15, Yoonseok Heo16, Byung Hwa Jung17,18. 1. Molecular Recognition Research Center, Korea Institute of Science and Technology (KIST), Hwarangno 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea. 2. Division of Bio-Medical Science and Technology, KIST-School, Korea University of Science and Technology (UST), Seoul, Republic of Korea. 3. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 4. Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea. 5. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 6. Department of Surgery, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea. 7. Department of Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea. 8. Department of Surgery, Soonchunhyang University Hospital, Seoul, Republic of Korea. 9. Department of Surgery, H+ Yangji Hospital, Seoul, Republic of Korea. 10. Department of Surgery, Keimyung University Dongsan Hospital, Daegu, Republic of Korea. 11. Department of Surgery, CHA Gangnam Medical Center, Seoul, Republic of Korea. 12. Department of Surgery, Cheil General Hospital, Seoul, Republic of Korea. 13. Department of Surgery, Asan Medical Center, Seoul, Republic of Korea. 14. Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 15. Department of Surgery, Ajou University Hospital, Suwon, Republic of Korea. 16. Department of Surgery, Inha University Hospital, Incheon, Republic of Korea. 17. Molecular Recognition Research Center, Korea Institute of Science and Technology (KIST), Hwarangno 14-gil 5, Seongbuk-gu, Seoul, 02792, Republic of Korea. jbhluck@kist.re.kr. 18. Division of Bio-Medical Science and Technology, KIST-School, Korea University of Science and Technology (UST), Seoul, Republic of Korea. jbhluck@kist.re.kr.
Abstract
INTRODUCTION: Bariatric surgery is known to be the most effective treatment for weight loss in obese patients and for the rapid remission of obesity-related comorbidities. These short-term improvements result from not only limited digestion or absorption but also dynamic changes in metabolism throughout the whole body. However, short-term metabolism studies associated with bariatric surgery in Asian individuals have not been reported. OBJECTIVES: The aim of this study was to investigate the short-term metabolome changes in the serum promoted by laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) and to determine the underlying mechanisms that affect obesity-related comorbidities. METHODS: Serum samples were collected from Korean patients who underwent RYGB or SG before and 4 weeks after the surgery. Metabolomic and lipidomic profiling was performed using UPLC-Orbitrap-MS, and data were analyzed using statistical analysis. RESULTS: Metabolites mainly related to amino acids, lipids (fatty acids, glycerophospholipids, sphingolipids, glycerolipids) and bile acids changed after surgery, and these changes were associated with the lowering of risk factors for obesity-related diseases such as nonalcoholic fatty liver disease (NAFLD), type 2 diabetes (T2D) and atherosclerosis. Interestingly, the number of significantly altered metabolites related to the lipid metabolism were greater in SG than in RYGB. Furthermore, the metabolites related to amino acid metabolism were significantly changed only after SG, whereas bile acid changed significantly only following RYGB. CONCLUSION: These differences could result from anatomical differences between the two surgeries and could be related to the gut microbiota. This study provides crucial information to expand the knowledge of the common but different molecular mechanisms involved in obesity and obesity-related comorbidities affected by each bariatric procedure.
INTRODUCTION: Bariatric surgery is known to be the most effective treatment for weight loss in obese patients and for the rapid remission of obesity-related comorbidities. These short-term improvements result from not only limited digestion or absorption but also dynamic changes in metabolism throughout the whole body. However, short-term metabolism studies associated with bariatric surgery in Asian individuals have not been reported. OBJECTIVES: The aim of this study was to investigate the short-term metabolome changes in the serum promoted by laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) and to determine the underlying mechanisms that affect obesity-related comorbidities. METHODS: Serum samples were collected from Korean patients who underwent RYGB or SG before and 4 weeks after the surgery. Metabolomic and lipidomic profiling was performed using UPLC-Orbitrap-MS, and data were analyzed using statistical analysis. RESULTS: Metabolites mainly related to amino acids, lipids (fatty acids, glycerophospholipids, sphingolipids, glycerolipids) and bile acids changed after surgery, and these changes were associated with the lowering of risk factors for obesity-related diseases such as nonalcoholic fatty liver disease (NAFLD), type 2 diabetes (T2D) and atherosclerosis. Interestingly, the number of significantly altered metabolites related to the lipid metabolism were greater in SG than in RYGB. Furthermore, the metabolites related to amino acid metabolism were significantly changed only after SG, whereas bile acid changed significantly only following RYGB. CONCLUSION: These differences could result from anatomical differences between the two surgeries and could be related to the gut microbiota. This study provides crucial information to expand the knowledge of the common but different molecular mechanisms involved in obesity and obesity-related comorbidities affected by each bariatric procedure.