Table 1.
Summary of parallel arm studies comparing the metabolomic profiles induced by different bariatric surgery interventions
| FIRST AUTHOR AND YEAR | EXPERIMENTAL DESIGN | PARTICIPANTS | SURGERY GROUPS | AGE AT SURGERY (YEARS) | FEMALE: MALE | PRE-OPERATIVE BMI (kg/m2) |
TIME AFTER SURGERY | POST-OPERATIVE BMI (kg/m2) | SAMPLE TYPE | METABOLOMIC METHOD | MAIN FINDINGS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LAGB vs RYGB | |||||||||||
| Magkos et al. (2013) [18] | Prospective cohort study |
Patients with obesity and NGT (N = 20) |
LAGB (n = 10) |
47 ± 14 | 9:1 | 46.5 ± 8.8 | 22 ± 7 weeks | 37.6 ± 7.3 | Fasting plasma |
Targeted MS/MS (AAs and acylcarnitine) |
↓ BCAAs and acylcarnitines after both surgeries in similar proportions |
|
RYGB (n = 10) |
43 ± 7 | 8:2 | 45.6 ± 6.7 | 16 ± 2 weeks | 36.4 ± 5.0 | ||||||
|
Lips et al. (2014) [31] |
Prospective cohort study |
Patients with obesity and NGT (N = 74: n = 27 submitted to bariatric surgeries) |
LAGB (n = 11) |
46.3 ± 1.9 | 11:0 | 43.1 ± 0.9 | 3 weeks | 41.10 ± 0.85 | Fasting plasma |
Targeted UPLC–tandem MS (AAs analysis) |
↓ BCAAs after both surgeries ↓ BCAAs was higher in patients submitted to RYGB ↑ Glycine and serine after RYGB ↓ AAAs after RYGB |
| 3 months | 39.02 ± 0.82 | ||||||||||
|
RYGB (n = 16) |
48.6 ± 1.6 | 16:0 | 44.2 ± 0.8 | 3 weeks | 40.48 ± 0.85 | ||||||
| 3 months | 36.63 ± 0.82 | ||||||||||
| Kayser et al. (2017) [50] | Prospective cohort study |
Patients with obesity and at least one severe obesity-related comorbidity (N = 59) |
LAGB (n = 22) |
34.5 ± 1.6 | 22:0 | 43.6 ± 0.7 | 1 month | 40.4 ± 1.0 | Fasting serum | Targeted LC–MS/MS (lipidomic) |
↓ equivalently in the majority of lipids between both surgical groups ↓ some PC and SM species at 1 month after surgery and remained suppressed 3 months after RYGB, while either returned or tended to return to baseline values 3 months after LAGB |
| 3 months | 38.3 ± 1.0 | ||||||||||
|
RYGB (n = 37) |
37.3 ± 1.9 | 37:0 | 46.5 ± 1.0 | 1 month | 41.1 ± 1.1 | ||||||
| 3 months | 38.0 ± 1.2 | ||||||||||
| SG vs RYGB | |||||||||||
| Jüllig et al. (2014) [39] | Prospective cohort study |
Patients with obesity and T2D (N = 15) |
SG (n = 7) |
46.8 ± 2.9 | 6:1 | 42.1 ± 4.0 | 3 days | NA | Fasting plasma |
Untargeted GC–MS |
↓ histidine, proline, citrate and decanoic acid after RYGB ↑ 2-hydroxybutyrate and 3-methyl-2-oxo-pentanoic acid after SG |
|
RYGB (n = 8) |
41.0 ± 3.1 | 8:0 | 42.1 ± 4.0 | 3 days | NA | ||||||
| Samczuk et al. (2018) [37] | Prospective cohort study |
Patients with obesity and T2D (N = 54) |
SG (n = 34) |
49.3 ± 8.7 | 14:20 | 50.92 ± 7.33 | 1 month | 45.90 ± 6.9 | Fasting serum | Untargeted GC–MS and LC–MS |
↓ AAAs induced by SG was higher ↑ P-cresol after SG ↑ sulfate-containing metabolites after RYGB ↓ PC, LPC, PE and LPE after both surgeries ↑ sphingomyelins and choline after both surgeries |
| 6 months | 37.33 ± 7.3 | ||||||||||
|
RYGB (n = 20) |
50.1 ± 9.3 | 15:5 | 45.79 ± 5.5 | 1 month | 40.97 ± 5.15 | ||||||
| 6 months | 32.61 ± 5.5 | ||||||||||
|
Tan et al. (2016) [33] |
Prospective cohort study |
Patients with obesity* (N = 22, 13 with T2D) |
SG (n = 12) |
36.3 ± 8 | 13:9 | 38.8 ± 1.3 | 12 months | NA | Fasting serum |
Targeted LC/MS (AAs and acylcarnitine) |
↓ BCAAs after both surgeries in similar proportions ↓ AAAs after SG |
|
RYGB (n = 10) |
45.6 ± 9.1 | 12 months | NA | ||||||||
| Gralka et al. (2015) [27] | Prospective cohort study |
Patients with obesity (N = 106) |
SG (n = 19) |
43.6 ± 1.0 | 73:33 | 53.6 ± 10.0 | 3 months | 46.0 ± 10.1 | Fasting serum | Untargeted 1H-NMR |
Metabolomic effect of RYGB are higher compared with SG ↓ BCCAs and AAAs after both bariatric surgeries. ↓ in valine was weaker after SG Carboxylic acids anions levels were modified similarly by the different bariatric surgeries ↑ TMAO after SG ↑ in dimethyl sulfates after surgery was higher in the distal RYGB |
| 6 months | 38.3 ± 10.0 | ||||||||||
| 9 months | 33.3 ± 6.1 | ||||||||||
| 12 months | 31.7 ± 4.1 | ||||||||||
|
Proximal RYGB (n = 27) |
43.0 ± 5.8 | 3 months | 36.7 ± 5.5 | ||||||||
| 6 months | 32.6 ± 5.4 | ||||||||||
| 9 months | 30.0 ± 5.5 | ||||||||||
| 12 months | 29.4 ± 5.9 | ||||||||||
| Distal RYGB (n = 60) | 46.3 ± 6.5 | 3 months | 39.1 ± 5.5 | ||||||||
| 6 months | 35.2 ± 5.4 | ||||||||||
| 9 months | 32.4 ± 5.2 | ||||||||||
| 12 months | 30.7 ± 4.9 | ||||||||||
| RYGB with short BPL vs RYGB with long BPL | |||||||||||
| Jarak et al. (2020) [53] | Cross-seccional study |
Patients with obesity and NGT (N = 20) |
RYGB with short BPL (n = 9) |
38 ± 3 | 8:1 | 41.8 ± 1.1 | 1.6 ± 0.3 years | 28.1 ± 2.3 | Fasting and post-prandial plasma | Untargeted 1H-NMR |
Fasting similar global profiles between groups ↑ post-prandial acetate in patients submitted to RYGB with long BPL |
|
RYGB with long BPL (n = 11) |
43 ± 2 | 10:1 | 40.6 ± 0.9 | 1.5 ± 0.3 years | 26.2 ± 2.8 | ||||||
| SG vs BPD | |||||||||||
| Ramos-Molina et al. (2018) [47] | Prospective cohort study |
Patients with obesity and NGT (N = 37) |
SG (n = 25) |
47.0 ± 6.7 | 16:9 | 47.9 ± 6.1 | 6 months | 36.5 ± 4.5 | Fasting plasma |
Targeted UPLC-MS (lipidomic) |
Lipidomic profiles induced by the two surgeries are different BPD: ↓ sphingolipids and phospholipids; ↑ bile acids SG: ↑ sphingolipids and phospholipids; no changes in bile acids levels |
| BPD (n = 12) | 44.4 ± 8.2 | 6:6 | 51.8 ± 6.9 | 6 months | 39.7 ± 4.4 | ||||||
| BPD-DS vs RYGB | |||||||||||
| Ahlin et al. (2019) [46] | Prospective cohort study |
Patients with obesity and NGT (N = 15) |
BPD (n = 9) | 44.7 ± 8.1 | 5:4 | 55.8 ± 9.5 | 183.7 ± 61.8 | 39.1 ± 8.5 | Fasting plasma |
Targeted UPLC-MS (bile acids analysis) |
No differences in fasting bile acid levels were observed between the RYGB and BPD groups |
| RYGB (n = 6) | 43. 7 ± 9.4 | 0:6 | 45.3 ± 5.7 | 187.8 ± 93.6 | 35.5 ± 5.5 | ||||||
| BPD-DS vs SADI-S | |||||||||||
| Pereira et al. (2020) [52] | Cross-seccional study |
Patients with obesity and NGT (N = 18) |
BPD-DS (n = 9) |
36 ± 12 | 6:3 | 51.9 ± 4.0 | 1.6 ± 0.3 years | 29.7 ± 4.3 | Fasting and post-prandial plasma | Untargeted 1H-NMR |
Fasting similar global profiles between groups ↑ post-prandial BCAAs in SADI-S group |
|
SADI-S (n = 9) |
43 ± 7 | 7:2 | 52.0 ± 3.7 | 1.5 ± 0.3 years | 30.0 ± 3.6 | ||||||
AA amino acids, AAA aromatic amino acids, BCCA branched chain amino acids, BMI body mass index, BPD biliopancreatic diversion, BPD-DS biliopancreatic diversion with duodenal switch, BPL biliopancreatic limb, GC gas chromatography, 1H-NMR proton nuclear magnetic resonance, LAGB laparoscopic adjustable gastric band, LC liquid chromatography, MS mass spectrometry, NA not available, NGT normal glucose tolerance, PC phosphatidylcholines, LPC lysophosphatidylcholines, PE phosphatidylethanolamines, SG sleeve gastrectomy, RYGB roux-en-Y gastric bypass, SADI-S single anastomosis with duodeno-Ileal bypass with sleeve gastrectomy, T2D type 2 diabetes, TMAO trimethylamine N-oxide, UPLC ultra-performance liquid chromatography
*Asian cohort