scholarly journals Metabolic and Hormonal Alterations Induced by Roux-en-Y Gastric Bypass

2017 ◽  
Author(s):  
Loqmane Seridi ◽  
Gregory C. Leo ◽  
G. Lynis Dohm ◽  
Walter J. Pories ◽  
James Lenhard

AbstractRoux-en-Y gastric bypass (RYGB) is an effective way to lose weight and reverse type 2 diabetes. We profiled the metabolome of 18 obese patients (nine euglycemic and nine diabetics) that underwent RYGB surgery and seven lean subjects. Plasma samples from the obese patients were collected before the surgery and one week and three months after the surgery. We analyzed the metabolome in association to five hormones (Adiponectin, Insulin, Ghrelin, Leptin, and Resistin), four peptide hormones (GIP, Glucagon, GLP1, and PYY), and two cytokines (IL-6 and TNF). PCA showed samples cluster by surgery time and many microbially driven metabolites (indoles in particular) correlated with the three months after the surgery. Network analysis of metabolites revealed a connection between carbohydrate (mannosamine and glucosamine) and glyoxylate and confirms glyoxylate association to diabetes. Only leptin and IL-6 had a significant association with the measured metabolites. Leptin decreased immediately after RYGB (before significant weight loss), whereas IL-6 showed no consistent response to RYGB. Moreover, leptin associated with tryptophan in support of the possible role of leptin in the regulation of serotonin synthesis pathways in the gut. These results suggest a potential link between gastric leptin and microbial-derived metabolites in the context of obesity and diabetes.

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243918
Author(s):  
Elin Rebecka Carlsson ◽  
Mogens Fenger ◽  
Trine Henriksen ◽  
Laura Kofoed Kjaer ◽  
Dorte Worm ◽  
...  

Increased oxidative stress in obesity and diabetes is associated with morbidity and mortality risks. Levels of oxidative damage to DNA and RNA can be estimated through measurement of 8-oxo-7,8-dihydro-2´-deoxyguanosine (8-oxodG) and 8-oxo-7,8-dihydroguanosine (8-oxoGuo) in urine. Both markers have been associated with type 2 diabetes, where especially 8-oxoGuo is prognostic for mortality risk. We hypothesized that Roux-en-Y gastric bypass (RYGB) surgery that has considerable effects on bodyweight, hyperglycemia and mortality, might be working through mechanisms that reduce oxidative stress, thereby reducing levels of the urinary markers. We used liquid chromatography coupled with tandem mass spectrometry to analyze the content of 8-oxodG and 8-oxoGuo in urinary samples from 356 obese patients treated with the RYGB-procedure. Mean age (SD) was 44.2 (9.6) years, BMI was 42.1 (5.6) kg/m2. Ninety-six (27%) of the patients had type 2 diabetes. Excretion levels of each marker before and after surgery were compared as estimates of the total 24-hour excretion, using a model based on glomerular filtration rate (calculated from cystatin C, age, height and weight), plasma- and urinary creatinine. The excretion of 8-oxodG increased in the first months after RYGB. For 8-oxoGuo, a gradual decrease was seen. Two years after RYGB and a mean weight loss of 35 kg, decreased hyperglycemia and insulin resistance, excretion levels of both markers were reduced by approximately 12% (P < 0.001). For both markers, mean excretion levels were about 30% lower in the female subgroup (P < 0.0001). Also, in this subgroup, excretion of 8-oxodG was significantly lower in patients with than without diabetes. We conclude, that oxidative damage to nucleic acids, reflected in the excretion of 8-oxodG and 8-oxoGuo, had decreased significantly two years after RYGB—indicating that reduced oxidative stress could be contributing to the many long-term benefits of RYGB-surgery in obesity and type 2 diabetes.


2008 ◽  
Vol 116 (2) ◽  
pp. 113-123 ◽  
Author(s):  
Margaret J. Hill ◽  
David Metcalfe ◽  
Philip G. McTernan

Although specific pathogenic entities contributing to diabetic risk, such as central adiposity, ectopic fat accumulation, hyperlipidaemia and inflammation, are well-characterized, the response of cellular systems to such insults are less well understood. This short review highlights the effect of increasing fat mass on ectopic fat accumulation, the role of triacylglycerols (triglycerides) in Type 2 diabetes mellitus and cardiovascular disease pathogenesis, and selected current therapeutic strategies used to ameliorate these risk factors.


2017 ◽  
Vol 95 (10) ◽  
pp. 1141-1148 ◽  
Author(s):  
Victoria Sid ◽  
Yaw L. Siow ◽  
Karmin O

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of chronic liver conditions that are characterized by steatosis, inflammation, fibrosis, and liver injury. The global prevalence of NAFLD is rapidly increasing in proportion to the rising incidence of obesity and type 2 diabetes. Because NAFLD is a multifaceted disorder with many underlying metabolic abnormalities, currently, there is no pharmacological agent that is therapeutically approved for the treatment of this disease. Folate is a water-soluble B vitamin that plays an essential role in one-carbon transfer reactions involved in nucleic acid biosynthesis, methylation reactions, and sulfur-containing amino acid metabolism. The liver is the primary organ responsible for storage and metabolism of folates. Low serum folate levels have been observed in patients with obesity and diabetes. It has been reported that a low level of endogenous folates in rodents perturbs folate-dependent one-carbon metabolism, and may be associated with development of metabolic diseases such as NAFLD. This review highlights the biological role of folate in the progression of NAFLD and its associated metabolic complications including obesity and type 2 diabetes. Understanding the role of folate in metabolic disease may position this vitamin as a potential therapeutic for NAFLD.


2015 ◽  
Vol 228 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Xinrong Zhou ◽  
Bangguo Qian ◽  
Ning Ji ◽  
Conghui Lui ◽  
Zhiyuan Liu ◽  
...  

Gastric bypass surgery produces clear antidiabetic effects in a substantial proportion of morbidly obese patients. In view of the recent trend away from ‘bariatric’ surgery and toward ‘metabolic’ surgery, it is important to elucidate the enhancing effect of bypass surgery on pancreatic β-cell mass, which is related to diabetes remission in non-obese patients. We investigated the effects of gastric bypass surgery on glycemic control and other pancreatic changes in a spontaneous non-obese type 2 diabetes Goto-Kakizaki rat model. Significant improvements in postprandial hyperglycemia and plasma c-peptide level were observed when glucose was administered orally post-surgery. Other important events observed after surgery were enhanced first phase insulin secretion in a in site pancreatic perfusion experiment, pancreatic hyperplasia, improved islet structure (revealed by immunohistochemical analysis), striking increase in β-cell mass, slight increase in ratio of β-cell area to total pancreas area, and increased number of small islets closely related to exocrine ducts. No notable changes were observed in ratio of β-cell to non-β endocrine cell area, β-cell apoptosis, or β-cell proliferation. These findings demonstrate that gastric bypass surgery in this rat model increases endocrine cells and pancreatic hyperplasia, and reflect the important role of the gastrointestinal system in regulation of metabolism.


2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Mirella P. Hage ◽  
Bassem Safadi ◽  
Ibrahim Salti ◽  
Mona Nasrallah

Bariatric surgery is currently the most effective and durable therapy for obesity. Roux-en-Y gastric bypass surgery, the most commonly performed procedure worldwide, causes substantial weight loss and improvement in several comorbidities associated with obesity, especially type 2 diabetes. Several mechanisms are proposed to explain the improvement in glucose metabolism after RYGB surgery: the caloric restriction and weight loss per se, the improvement in insulin resistance and beta cell function, and finally the alterations in the various gastrointestinal hormones and adipokines that have been shown to play an important role in glucose homeostasis. However, the timing, exact changes of these hormones, and the relative importance of these changes in the metabolic improvement postbariatric surgery remain to be further clarified. This paper reviews the various changes post-RYGB in adipokines and gut peptides in subjects with T2D.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Abbasihormozi ◽  
A Kouhkan ◽  
A Shahverdi ◽  
A Parhizkar ◽  
Z Zolfaghary ◽  
...  

Abstract Study question To evaluate the association between sperm functionality parameters and biochemical, hormonal, and inflammatory indices in obese and diabetic men. Summary answer Metabolic changes,hormonal dysfunction,and the presence of inflammatory mediators might be considered possible mechanisms in the development of sub-fertility in obese and diabetic sub-fertile men What is known already Although the higher prevalence of subfertility in obese and diabetic men during the reproductive age is evident, the mechanisms by which obesity and diabetes mellitus (DM) cause male infertility are not entirely understood. Several pathways might be involved in the role of obesity in semen quality, thereby inducing alterations in hormonal profiles, abnormal lipid metabolism, and possibly the formation of inflammatory cytokines, ultimately leading to impaired sperm function Study design, size, duration We enrolled normal weight (BMI&lt;25 kg/m2) and non-type–2 diabetic (control=40), obese and non- type–2 diabetic (obese=40), non-obese and type–2 diabetic (Lean-DM=35), and obese and type–2 diabetic (Obese-DM=35) sub-fertile men, aged 20–50 years, referring to Royan infertility clinic (Tehran, Iran) from March to September 2014 Participants/materials, setting, methods After enrollment and receiving informed consent, all men underwent face-to-face private interviews. The obesity-associated markers, insulin resistance, beta-cell function, hormonal and lipid profile, inflammatory indices, and semen analysis were assessed in four experimental groups. Semen analysis was examined after 2–5 days of sexual analysis).abstinence based on WHO-recommended methods by CASA system (computer-assisted sperm Main results and the role of chance Main results and the role of chance: Our finding showed that diabetic markers were significantly increased in two diabetic groups, while obesity indices were markedly increased in two obese groups. Conventional sperm parameters were significantly lower in obese DM, lean DM, and obese groups compared with the control (p &lt; 0.05). Serum levels of total testosterone (TT) and sex hormone-binding globulin (SHBG) were significantly lower in men with obesity and DM compared with the control (p &lt; 0.05).There was a significant difference in the concentration of high-sensitivity C-reactive protein (hs-CRP) among four experimental groups. Moreover, serum leptin was significantly increased in obese DM, lean DM, and obese groups. Serum insulin levels had a positive correlation with metabolic-associated indices (WC, BMI, FBS,HbA1c,and HOMA-IR), as well as hs-CRP levels, whereas it had a negative correlation with count, motility, and morphology. There is also a negative association between metabolic-associated indices (WC, BMI, FBS, HbA1c, and HOMA-IR) and semen parameters. Limitations, reasons for caution It was better to evaluate inflammatory biomarkers be examined in other tissues Wider implications of the findings: The results of this study demonstrated the association of metabolic changes, hormonal dysfunction, and inflammatory responses with the semen parameters of sub-fertile men with obesity and diabete. Trial registration number Not applicable


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