TY - GEN
T1 - Long-term metabolomic effects of bariatric surgery
AU - Smith, Madeleine L
AU - Goudswaard, Lucy
AU - Corbin, Laura J
AU - Timpson, Nicholas John
AU - The By-Band-Sleeve Trial Management Group,
PY - 2022/6
Y1 - 2022/6
N2 - Bariatric surgery has been shown to cause early changes to the metabolome that have implications for disease including remission of type 2 diabetes (T2D). However, previous studies have been limited by small sample sizes and lack of long-term follow-up. The By-Band-Sleeve study is an ongoing multi-centre randomized controlled trial comparing clinical effectiveness of three types of bariatric surgery: laparoscopic adjustable gastric band, Roux-en-Y gastric bypass and sleeve gastrectomy. Over 1300 participants have been recruited to the trial and randomized to one of the three surgical procedures. Using blood samples collected before and after surgery we aim to assess the long-term effects of bariatric surgery on the metabolome. Here we present results from an initial pilot of 125 By-Band-Sleeve participants. Serum samples collected at baseline and 36 months post-randomization were analyzed using mass spectrometry (UPLC-MS/MS). In a preliminary analysis of these 250 paired samples, we applied a paired Wilcoxon-signed rank test to compare levels of 973 metabolites at 36 months versus baseline. 192 metabolites showed evidence of change (p<0.05/446, Bonferroni-adjusted according to number of independent metabolites). The most strongly associated metabolites included metabolonic lactone sulfate, which was decreased after surgery and has previously been observationally associated with high body mass index (BMI) and indicators of poor cardiometabolic health. Most of the associated metabolites belong to lipid or amino acid super-pathways. Weight loss is presumed to be a major driver of metabolic change, with published data from the National Bariatric Surgery Registry (UK) showing mean weight loss 3 years after bariatric surgery to be in the region of 20-30%. Next, we will use a more comprehensive model to assess metabolomic change after surgery, examining correlations with BMI change and other clinical factors such as T2D status and blood pressure. Future analyses will include comparisons with metabolomic signatures of non-surgical weight loss interventions.
AB - Bariatric surgery has been shown to cause early changes to the metabolome that have implications for disease including remission of type 2 diabetes (T2D). However, previous studies have been limited by small sample sizes and lack of long-term follow-up. The By-Band-Sleeve study is an ongoing multi-centre randomized controlled trial comparing clinical effectiveness of three types of bariatric surgery: laparoscopic adjustable gastric band, Roux-en-Y gastric bypass and sleeve gastrectomy. Over 1300 participants have been recruited to the trial and randomized to one of the three surgical procedures. Using blood samples collected before and after surgery we aim to assess the long-term effects of bariatric surgery on the metabolome. Here we present results from an initial pilot of 125 By-Band-Sleeve participants. Serum samples collected at baseline and 36 months post-randomization were analyzed using mass spectrometry (UPLC-MS/MS). In a preliminary analysis of these 250 paired samples, we applied a paired Wilcoxon-signed rank test to compare levels of 973 metabolites at 36 months versus baseline. 192 metabolites showed evidence of change (p<0.05/446, Bonferroni-adjusted according to number of independent metabolites). The most strongly associated metabolites included metabolonic lactone sulfate, which was decreased after surgery and has previously been observationally associated with high body mass index (BMI) and indicators of poor cardiometabolic health. Most of the associated metabolites belong to lipid or amino acid super-pathways. Weight loss is presumed to be a major driver of metabolic change, with published data from the National Bariatric Surgery Registry (UK) showing mean weight loss 3 years after bariatric surgery to be in the region of 20-30%. Next, we will use a more comprehensive model to assess metabolomic change after surgery, examining correlations with BMI change and other clinical factors such as T2D status and blood pressure. Future analyses will include comparisons with metabolomic signatures of non-surgical weight loss interventions.
M3 - Conference Contribution (Conference Proceeding)
BT - Metabolomics 2022
ER -
