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The Effects of Sleeve Gastrectomy and Gastric Bypass on Branched-Chain Amino Acid Metabolism 1 Year After Bariatric Surgery

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Abstract

Background

Weight loss, early after Roux-en-Y gastric bypass (GB) surgery, is associated with reduced concentrations of plasma branched-chain amino acids (BCAAs) and improved insulin sensitivity. Herein, we evaluated whether changes in BCAAs and insulin sensitivity persist with weight stabilization (1 year) after GB or sleeve gastrectomy (SG).

Methods

We prospectively examined 22 severely obese patients (mean age 40.6 ± 2.1 years, BMI 38.8 ± 1.3 kg/m2, and 59.1 % female) who underwent SG (n = 12) or GB (n = 10) for morbid obesity. Body fat composition was measured with dual X-Ray absorptiometry and abdominal fat volume with computed tomography. BCAAs and acylcarnitines were profiled using liquid chromatography with tandem mass spectrometry. Insulin resistance was calculated using the homeostasis model assessment for insulin resistance (HOMA-IR) formula.

Results

At 1-year follow-up, the decrease in BMI, body weight, total fat mass (TFM), fat free mass, and visceral adipose tissue (VAT) was similar between SG and GB. HOMA-IR was associated with BCAA concentrations, and both were decreased equally in both surgical groups. In multivariate analysis with BCAAs, TFM, and VAT as independent factors, only VAT remained significantly associated with insulin resistance.

Conclusions

The metabolic benefits from bariatric surgery, including the changes in BCAA profile, are comparable between SG and GB. The reduction in BCAAs and improvement in the AC profiles after bariatric surgery persists up to 12 months after surgery and may not be surgical related but is influenced primarily by the amount of weight loss, in particular the reduction in visceral adiposity.

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Acknowledgments

All authors were involved in writing the paper and had final approval of the submitted and published versions. The authors would like to thank Stephanie Chung, Vieon Wu, Valerie Lai, and Sharon Gan for their research coordinating efforts and Garrett Ong, Kim Huey Ee, Kevin Timothy Fridianto, and Tse Yin Tan for their laboratory expertise. We are very thankful to the study volunteers.

Funding

This work was supported by the SingHealth Foundation (SHEF 28170370) and Singapore General Hospital Department of Clinical Research Bridging Grant (DCRBG/01/2014).

Author information

Authors and Affiliations

  1. Department of Endocrinology, Singapore General Hospital, The Academia Level 3, 20 College Road, Singapore, 169856, Singapore

    Hong Chang Tan, Matthew Zhen-Wei Tan & Kwang Wei Tham

  2. Department of Medicine, National University of Singapore, Singapore, Singapore

    Chin Meng Khoo

  3. Cardiovascular Metabolic Program, DUKE-NUS Graduate Medical School, Singapore, Singapore

    Chin Meng Khoo, Jean-Paul Kovalik & Jian Hong Ching

  4. The Endocrine Clinic, Mount Elizabeth Novena Specialist Centre, Singapore, Singapore

    Alvin Choong Meng Ng

  5. Department of Upper GI and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore

    Alvin Kim Hock Eng

  6. Department of Clinical Research, Singapore General Hospital, Singapore, Singapore

    Oi Fah Lai

  7. Advanced Laparoscopic Surgery, Gleneagles Hospital, Singapore, Singapore

    Shanker Pasupathy

Authors
  1. Hong Chang Tan
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  2. Chin Meng Khoo
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  3. Matthew Zhen-Wei Tan
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  4. Jean-Paul Kovalik
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  5. Alvin Choong Meng Ng
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  6. Alvin Kim Hock Eng
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  7. Oi Fah Lai
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  8. Jian Hong Ching
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  9. Kwang Wei Tham
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  10. Shanker Pasupathy
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Correspondence to Hong Chang Tan.

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The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Tan, H.C., Khoo, C.M., Tan, M.ZW. et al. The Effects of Sleeve Gastrectomy and Gastric Bypass on Branched-Chain Amino Acid Metabolism 1 Year After Bariatric Surgery. OBES SURG 26, 1830–1835 (2016). https://doi.org/10.1007/s11695-015-2023-x

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  • DOI: https://doi.org/10.1007/s11695-015-2023-x

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