Metabolic alterations in plasma after laparoscopic sleeve gastrectomy

Abstract

Laparoscopic sleeve gastrectomy (LSG) is an important therapeutic option for morbidly obese patients. Although LSG promotes sufficient weight loss, how LSG changes plasma metabolites remains unclear. We assessed changes in plasma metabolite levels after LSG. We collected plasma samples from 15 morbidly obese Japanese patients before and 3 months after LSG. A total of 48 metabolites were quantified using capillary electrophoresis time-of-flight mass spectrometry-based metabolomic profiling. Branched chain amino acids, several essential amino acids, choline, 2-hydroxybutyric acid, 2-oxoisovaleric acid and hypoxanthine were significantly decreased after LSG. Tricarboxylic acid cycle metabolites, including citric acid, succinic acid and malic acid, were significantly elevated after LSG. This is the first report to show dynamic alterations in plasma metabolite concentrations, as assessed using capillary electrophoresis time-of-flight mass spectrometry, in morbidly obese patients after LSG. Our results might show how LSG helps improve obesity, in part through metabolic status changes, and propose novel therapeutic targets to ameliorate obesity.

Long-Term Effects of Bariatric Surgery on Gut Microbiota Composition and Faecal Metabolome Related to Obesity Remission

“…In fact, methyl acetoacetate, carbamoyl aspartate and serine phosphate increased, whereas metabolites such as 5-aminolevulinic acid, choline, citric acid, malic acid, taurine, TMAO and tropic acid decreased in faeces, suggesting that long-term effects of surgical intervention affected this characteristic metabolomic profile. In this sense, previous studies described a reduction in choline [47,48], TMAO [48,49], taurine [50] or citric acid [49] with bariatric surgery, which agree with our results. Moreover, taurine was positively correlated with insulin and AST levels, whereas citric acid was correlated with the parameters AST, ALT and BMI.…”

Metabolomic signatures after bariatric surgery – a systematic review

“…The upregulation of BCAAs catabolism is supported by the consistent postoperative decline of specific subproducts of BCAAs' mitochondrial oxidation, namely short chain acylcarnitine's C3 and C5 [17,18,28,30,43]. Although BCAAs decrease after both restrictive and malabsorptive surgeries [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][35][36][37], parallel arm studies reported a greater effect of RYGB in BCAAs levels [27,31]. Since the differences found in BCAA levels when comparing RYGB and the restrictive procedures seem to be independent of the weight loss, these were hypothesized to be related to impaired AAs absorption induced by the RYGB intestinal rearrangement [27,31].…”

“…Numerous studies demonstrated that circulating levels of valine [ 17 – 34 ], isoleucine [ 17 – 24 , 26 , 27 , 29 – 36 ], leucine [ 17 – 24 , 26 , 27 , 29 – 33 , 35 – 37 ], phenylalanine [ 17 , 18 , 20 , 21 , 23 , 24 , 26 – 29 , 37 ], tyrosine [ 17 – 21 , 23 , 24 , 27 , 29 , 30 , 37 ], tryptophan [ 17 , 21 , 24 , 29 , 37 , 38 ], alanine [ 17 – 21 , 23 , 28 , 30 , 33 , 39 ], proline [ 17 – 19 , 21 , 28 , 39 ], methionine [ 18 , 23 , 30 ], aspartate [ 21 ], threonine [ 19 , 21 , 32 ], lysine [ 19 ] and ornithine [ 18 , 21 , 24 , 30 , 40 ] decrease after bariatric surgery. Contrarily, circulating levels of glycine [ 18 – 22 , …”

“…Most studies reported a decrease in pyruvate [ 27 , 28 , 35 , 41 ] and lactate [ 19 , 28 , 32 ] levels after bariatric surgery. Contrarily, the Krebs cycle intermediates (citrate [ 19 , 24 , 27 , 37 ], succinate [ 24 , 38 ], fumarate [ 38 , 41 ], malate [ 24 , 41 ], oxalacetate [ 35 ]) were found to increase after surgery.…”

“…Numerous studies demonstrated that circulating levels of valine [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], isoleucine [17-24, 26, 27, 29-36], leucine [17-24, 26, 27, 29-33, 35-37], phenylalanine [17,18,20,21,23,24,[26][27][28][29]37], tyrosine [17-21, 23, 24, 27, 29, 30, 37], tryptophan [17,21,24,29,37,38], alanine [17-21, 23, 28, 30, 33, 39], proline [17-19, 21, 28, 39], methionine [18,23,30], aspartate [21], threonine [19,21,32], lysine [19] and ornithine [18,...…”