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Metabolites and diabetes remission after weight loss.

Publication ,  Journal Article
Kwee, LC; Ilkayeva, O; Muehlbauer, MJ; Bihlmeyer, N; Wolfe, B; Purnell, JQ; Xavier Pi-Sunyer, F; Chen, H; Bahnson, J; Newgard, CB; Shah, SH ...
Published in: Nutr Diabetes
February 24, 2021

There is marked heterogeneity in the response to weight loss interventions with regards to weight loss amount and metabolic improvement. We sought to identify biomarkers predictive of type 2 diabetes remission and amount of weight loss in individuals with severe obesity enrolled in the Longitudinal Assessment of Bariatric Surgery (LABS) and the Look AHEAD (Action for Health in Diabetes) studies. Targeted mass spectrometry-based profiling of 135 metabolites was performed in pre-intervention blood samples using a nested design for diabetes remission over five years (n = 93 LABS, n = 80 Look AHEAD; n = 87 remitters), and for extremes of weight loss at five years (n = 151 LABS; n = 75 with high weight loss). Principal components analysis (PCA) was used for dimensionality reduction, with PCA-derived metabolite factors tested for association with both diabetes remission and weight loss. Metabolic markers were tested for incremental improvement to clinical models, including the DiaRem score. Two metabolite factors were associated with diabetes remission: one primarily composed of branched chain amino acids (BCAA) and tyrosine (odds ratio (95% confidence interval) [OR (95% CI)] = 1.4 [1.0-1.9], p = 0.045), and one with betaine and choline (OR [95% CI] = 0.7 [0.5-0.9], p = 0.02).These results were not significant after adjustment for multiple tests. Inclusion of these two factors in clinical models yielded modest improvements in model fit and performance: in a constructed clinical model, the C-statistic improved from 0.87 to 0.90 (p = 0.02), while the net reclassification index showed improvement in prediction compared to the DiaRem score (NRI = 0.26, p = 0.0013). No metabolite factors associated with weight loss at five years. Baseline levels of metabolites in the BCAA and trimethylamine-N-oxide (TMAO)-microbiome-related pathways are independently and incrementally associated with sustained diabetes remission after weight loss interventions in individuals with severe obesity. These metabolites could serve as clinically useful biomarkers to identify individuals who will benefit the most from weight loss interventions.

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Published In

Nutr Diabetes

DOI

EISSN

2044-4052

Publication Date

February 24, 2021

Volume

11

Issue

1

Start / End Page

10

Location

England

Related Subject Headings

  • Weight Loss
  • Tyrosine
  • Treatment Outcome
  • Remission Induction
  • Obesity, Morbid
  • Obesity
  • Middle Aged
  • Methylamines
  • Mass Spectrometry
  • Male
 

Citation

APA
Chicago
ICMJE
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Kwee, L. C., Ilkayeva, O., Muehlbauer, M. J., Bihlmeyer, N., Wolfe, B., Purnell, J. Q., … Laferrère, B. (2021). Metabolites and diabetes remission after weight loss. Nutr Diabetes, 11(1), 10. https://doi.org/10.1038/s41387-021-00151-6
Kwee, Lydia Coulter, Olga Ilkayeva, Michael J. Muehlbauer, Nathan Bihlmeyer, Bruce Wolfe, Jonathan Q. Purnell, F. Xavier Pi-Sunyer, et al. “Metabolites and diabetes remission after weight loss.Nutr Diabetes 11, no. 1 (February 24, 2021): 10. https://doi.org/10.1038/s41387-021-00151-6.
Kwee LC, Ilkayeva O, Muehlbauer MJ, Bihlmeyer N, Wolfe B, Purnell JQ, et al. Metabolites and diabetes remission after weight loss. Nutr Diabetes. 2021 Feb 24;11(1):10.
Kwee, Lydia Coulter, et al. “Metabolites and diabetes remission after weight loss.Nutr Diabetes, vol. 11, no. 1, Feb. 2021, p. 10. Pubmed, doi:10.1038/s41387-021-00151-6.
Kwee LC, Ilkayeva O, Muehlbauer MJ, Bihlmeyer N, Wolfe B, Purnell JQ, Xavier Pi-Sunyer F, Chen H, Bahnson J, Newgard CB, Shah SH, Laferrère B. Metabolites and diabetes remission after weight loss. Nutr Diabetes. 2021 Feb 24;11(1):10.

Published In

Nutr Diabetes

DOI

EISSN

2044-4052

Publication Date

February 24, 2021

Volume

11

Issue

1

Start / End Page

10

Location

England

Related Subject Headings

  • Weight Loss
  • Tyrosine
  • Treatment Outcome
  • Remission Induction
  • Obesity, Morbid
  • Obesity
  • Middle Aged
  • Methylamines
  • Mass Spectrometry
  • Male