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Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss.

Publication ,  Journal Article
Laferrère, B; Reilly, D; Arias, S; Swerdlow, N; Gorroochurn, P; Bawa, B; Bose, M; Teixeira, J; Stevens, RD; Wenner, BR; Bain, JR; Haqq, A ...
Published in: Sci Transl Med
April 27, 2011

Glycemic control is improved more after gastric bypass surgery (GBP) than after equivalent diet-induced weight loss in patients with morbid obesity and type 2 diabetes mellitus. We applied metabolomic profiling to understand the mechanisms of this better metabolic response after GBP. Circulating amino acids (AAs) and acylcarnitines (ACs) were measured in plasma from fasted subjects by targeted tandem mass spectrometry before and after a matched 10-kilogram weight loss induced by GBP or diet. Total AAs and branched-chain AAs (BCAAs) decreased after GBP, but not after dietary intervention. Metabolites derived from BCAA oxidation also decreased only after GBP. Principal components (PC) analysis identified two major PCs, one composed almost exclusively of ACs (PC1) and another with BCAAs and their metabolites as major contributors (PC2). PC1 and PC2 were inversely correlated with pro-insulin concentrations, the C-peptide response to oral glucose, and the insulin sensitivity index after weight loss, whereas PC2 was uniquely correlated with levels of insulin resistance (HOMA-IR). These data suggest that the enhanced decrease in circulating AAs after GBP occurs by mechanisms other than weight loss and may contribute to the better improvement in glucose homeostasis observed with the surgical intervention.

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Published In

Sci Transl Med

DOI

EISSN

1946-6242

Publication Date

April 27, 2011

Volume

3

Issue

80

Start / End Page

80re2

Location

United States

Related Subject Headings

  • Weight Loss
  • Regression Analysis
  • Principal Component Analysis
  • Obesity
  • Middle Aged
  • Metabolic Networks and Pathways
  • Male
  • Humans
  • Gastric Bypass
  • Female
 

Citation

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Laferrère, B., Reilly, D., Arias, S., Swerdlow, N., Gorroochurn, P., Bawa, B., … Newgard, C. B. (2011). Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss. Sci Transl Med, 3(80), 80re2. https://doi.org/10.1126/scitranslmed.3002043
Laferrère, Blandine, David Reilly, Sara Arias, Nicholas Swerdlow, Prakash Gorroochurn, Baani Bawa, Mousumi Bose, et al. “Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss.Sci Transl Med 3, no. 80 (April 27, 2011): 80re2. https://doi.org/10.1126/scitranslmed.3002043.
Laferrère B, Reilly D, Arias S, Swerdlow N, Gorroochurn P, Bawa B, et al. Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss. Sci Transl Med. 2011 Apr 27;3(80):80re2.
Laferrère, Blandine, et al. “Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss.Sci Transl Med, vol. 3, no. 80, Apr. 2011, p. 80re2. Pubmed, doi:10.1126/scitranslmed.3002043.
Laferrère B, Reilly D, Arias S, Swerdlow N, Gorroochurn P, Bawa B, Bose M, Teixeira J, Stevens RD, Wenner BR, Bain JR, Muehlbauer MJ, Haqq A, Lien L, Shah SH, Svetkey LP, Newgard CB. Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss. Sci Transl Med. 2011 Apr 27;3(80):80re2.

Published In

Sci Transl Med

DOI

EISSN

1946-6242

Publication Date

April 27, 2011

Volume

3

Issue

80

Start / End Page

80re2

Location

United States

Related Subject Headings

  • Weight Loss
  • Regression Analysis
  • Principal Component Analysis
  • Obesity
  • Middle Aged
  • Metabolic Networks and Pathways
  • Male
  • Humans
  • Gastric Bypass
  • Female