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20.06.2020 | Original Contributions | Ausgabe 10/2020

Obesity Surgery 10/2020

Different Malabsorptive Obesity Surgery Interventions Result in Distinct Postprandial Amino Acid Metabolomic Signatures

Zeitschrift:
Obesity Surgery > Ausgabe 10/2020
Autoren:
Sofia S. Pereira, Ivana Jarak, Rui A. Carvalho, Pedro F. Oliveira, Marco G. Alves, Marta Guimarães, Rui Almeida, Ana M. Pereira, Nicolai J. Wewer Albrechtsen, Jens J. Holst, Mário Nora, Mariana P. Monteiro
Wichtige Hinweise
Sofia S. Pereira and Ivana Jarak contributed equally to this work.

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Abstract

Purpose

Biliopancreatic diversion with duodenal switch (BPD-DS) is an effective weight loss surgical procedure. Yet, BPD-DS is technically difficult to perform and carries a higher risk of nutrient deficiencies as compared with other surgical interventions. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a modified BPD-DS procedure conceived with the aim of decreasing the technical complexity, while retaining the weight loss efficiency. Whether the two surgical procedures diverge in nutrient absorption rates and malnutrition risk is still matter of debate. Our aim was to determine if postprandial nutrient absorption rates are different in patients subjected to BPD-DS or SADI-S for weight loss.

Materials and Methods

Plasma amino acid metabolomic profiling during mixed-meal tolerance test (MMTT) was performed in subjects (N = 18) submitted to BPD-DS (n = 9) or SADI-S (n = 9) 1.6 ± 0.1 years earlier.

Results

Patients submitted to SADI-S or BPD-DS presented distinct postprandial metabolomic profiles. Postprandial excursions of total and essential amino acids—leucine, isoleucine, and valine—were higher after SADI-S as compared with BPD-DS.

Conclusion

Our study demonstrates that a simplified malabsorptive bariatric surgery procedure SADI-S results in greater essential branched-chain amino acid absorption when compared with the classical BPD-DS intervention. These findings suggest that SADI-S can potentially lower lifetime risk of postoperative protein malnutrition, as well as have a positive impact on systemic metabolism and glucose homeostasis.

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