Differential Metabolic Impact of Gastric Bypass Surgery Versus Dietary Intervention in Obese Diabetic Subjects Despite Identical Weight Loss
作者： B. Laferrere , D. Reilly , S. Arias , N. Swerdlow , P. Gorroochurn
DOI: 10.1126/SCITRANSLMED.3002043
关键词:
摘要: Glycemic control is improved more after gastric bypass surgery (GBP) than 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 GBP. Circulating amino acids (AAs) acylcarnitines (ACs) were measured plasma from fasted subjects by targeted tandem mass spectrometry before a matched 10-kilogram induced GBP or diet. Total AAs branched-chain (BCAAs) decreased GBP, but not dietary intervention. Metabolites derived BCAA oxidation also only Principal components (PC) analysis identified two major PCs, one composed almost exclusively ACs (PC1) another BCAAs their metabolites as contributors (PC2). PC1 PC2 inversely correlated pro-insulin concentrations, C-peptide oral glucose, insulin sensitivity index loss, whereas was uniquely levels resistance (HOMA-IR). These data suggest that enhanced decrease circulating occurs other may contribute improvement glucose homeostasis observed surgical
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