Lipidomic profiling before and after Roux-en-Y gastric bypass in obese patients with diabetes
Lipidomic profiling before and after Roux-en-Y gastric bypass in obese patients with diabetes
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DOI：
10.1038/tpj.2013.42
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发表时间：
2014-06-01
影响因子：
2.8
通讯作者：
Bornstein, S. R.
中科院分区：
文献类型：
--
作者：
Graessler, J.;Bornstein, T. D.;Bornstein, S. R.
减肥手术是一种行之有效的方法，以改善代谢性疾病的病态肥胖患者的心血管风险高。术后脂质代谢的正常化在预防未来心血管事件中具有核心作用。因此，本研究的目的是表征血浆脂质组学模式的变化，包括13种脂质类的229种脂质，Roux-en-Y胃旁路术（RYGB）后3个月的病态肥胖患者和无糖尿病。RYGB导致体重指数降低15-32%，这与通过常规临床化学测量的总胆固醇（TC，28.3%; P=0.02）、LDL-胆固醇（LDL-C，-26.8%; P=0.03）和甘油三酯（TG，-63.0%; P= 0.05）显著降低相关。HDL-胆固醇保持不变。RYGB对血浆脂质谱的影响的特征在于显著降低了87种脂质物质，包括三酰甘油酯（TAG）、胆固醇酯（CholEs）、溶血磷脂酰胆碱（LPC）、磷脂酰胆碱（PC）、磷脂酰乙醇胺醚（PEO）、磷脂酰肌醇（Pis）和神经酰胺（Cers）。血脂成分总量下降了32.6%，66种血脂成分下降超过50%。对于24种单独的脂质种类（10种TAG、3种CholE、2种LPC、1种溶血磷脂酰胆碱醚（LPCO）（LPC醚）、1种PC、2种磷脂酰胆碱醚（PCO）和5种Cer），可以证明与HbAlc值的直接相关性。值得注意的是，两种脂质物质（TAG 58：5和PEO 40：5）与HbA（1c）呈负相关。LPCO作为一种单一的全脂蛋白，与HbA（1c）直接相关。这些数据表明，RYGB诱导的脂质组学谱的调制提供了有关术后代谢适应的重要信息，并可能大大有助于改善血糖控制。人血浆脂质组的这些显著变化可以解释RYGB对心血管系统、精神状态和免疫调节的急性、体重非依赖性和长期作用。
Bariatric surgery is a well-established approach to improve metabolic disease in morbidly obese patients with high cardiovascular risk. The post-operative normalization of lipid metabolism has a central role in the prevention of future cardiovascular events. The aim of the present study therefore was to characterize changes of plasma lipidomic patterns, consisting of 229 lipid species of 13 lipid classes, 3 months after Roux-en-Y gastric bypass (RYGB) in morbidly obese patients with and without diabetes. RYGB resulted in a 15-32% decrease of body mass index, which was associated with a significant reduction of total cholesterol (TC, 28.3%; P=0.02), LDL-cholesterol (LDL-C, -26.8%; P=0.03) and triglycerides (TGs, -63.0%; P= 0.05) measured by routine clinical chemistry. HDL-cholesterol remained unchanged. The effect of RYGB on the plasma lipidomic profile was characterized by significant decreases of 87 lipid species from triacylglycerides (TAGs), cholesterol esters (CholEs), lysophosphatidylcholines (LPCs), phosphatidylcholines (PCs), phosphatidylethanolamine ethers (PEOs), phosphatidylinositols (Pis) and ceramides (Cers). The total of plasma lipid components exhibited a substantial decline of 32.6% and 66 lipid species showed a decrease by over 50%. A direct correlation with HbAlc values could be demonstrated for 24 individual lipid species (10 TAG, three CholE, two LPC, one lysophosphatidylcholine ethers (LPCO) (LPC ether), one PC, two phosphatidylcholine ethers (PCO) and five Cer). Notably, two lipid species (TAG 58:5 and PEO 40:5) were inversely correlated with HbA(1c). LPCO, as single whole lipid class, was directly related to HbA(1c). These data indicate that RYGB-induced modulation of lipidomic profiles provides important information about postoperative metabolic adaptations and might substantially contribute to improvements of glycemic control. These striking changes in the human plasma lipidome may explain acute, weight independent and long-term effects of RYGB on the cardiovascular system, mental status and immune regulation.