Metabolomic signatures after bariatric surgery - a systematic review

Matilde Vaz, Sofia S Pereira, Mariana P Monteiro, Matilde Vaz, Sofia S Pereira, Mariana P Monteiro

Abstract

Metabolomics emerged as an important tool to gain insights on how the body responds to therapeutic interventions. Bariatric surgery is the most effective treatment for severe obesity and obesity-related co-morbidities. Our aim was to conduct a systematic review of the available data on metabolomics profiles that characterize patients submitted to different bariatric surgery procedures, which could be useful to predict clinical outcomes including weight loss and type 2 diabetes remission. For that, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines were followed. Data from forty-seven original study reports addressing metabolomics profiles induced by bariatric surgery that met eligibility criteria were compiled and summarized. Amino acids, lipids, energy-related and gut microbiota-related were the metabolite classes most influenced by bariatric surgery. Among these, higher pre-operative levels of specific lipids including phospholipids, long-chain fatty acids and bile acids were associated with post-operative T2D remission. As conclusion, metabolite profiling could become a useful tool to predict long term response to different bariatric surgery procedures, allowing more personalized interventions and improved healthcare resources allocation.

Keywords: Bariatric surgery; Metabolomics; Type 2 diabetes remission; Weight loss.

Conflict of interest statement

The authors have nothing to disclose.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of the search, eligibility criteria approaches and study inclusion for systematic review
Fig. 2
Fig. 2
Main metabolomic alterations induced by bariatric surgery, in patients with obesity. Abbreviations: 3-HB – 3-hydroxybutyrate; LCSFA – Long-Chain Saturated Fatty Acids; LPC – Lysophosphatidylcholine; MCSFA – Medium-Chain Saturated Fatty Acids; NEFA – Non-Esterified Fatty Acids; PE – Phosphatidylethanolamine; TCA – Tricarboxylic Acid
Fig. 3
Fig. 3
Metabolomic profiles of patients with successful weight loss/maintenance. Abbreviations: 5-HIAA – 5-hydroxyindoleacetic acid; 5-HTrp – 5-hydroxytryptophan; CDCA – Chenodeoxycholic Acid; CE – cholesterol esters; DG – diaglycerols; G- – glycine amidated; HCA – hyocholic acid, SG – Sleeve gastrectomy; RYGB – Roux-en-Y Gastric Bypass; TG – triacylglyceride
Fig. 4
Fig. 4
Metabolomic profiles of patients with T2D remission/improved insulin parameters. Abbreviations: BPD – Biliopancreatic diversion; DJB – Duodenal-jejunal bypass; HDL – High-density Lipoprotein; LCFA – long-chain free fatty acids; LDL – Low-density Lipoprotein; PE – Phosphatidylethanolamines; SG – Sleeve gastrectomy; RYGB – Roux-en-Y Gastric Bypass; TCA – Tricarboxylic Acid; VLDL – Very-low-density Lipoprotein

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