title: Lipidomic profiling before and after Roux-en-Y gastric bypass in obese patients with diabetes.
abstract: 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 HbA1C 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 HbA1C. LPCO, as single whole lipid class, was directly related to HbA1C. These data indicate that RYGB-induced modulation of lipidomic profiles provides important information about post-operative 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.
authors.affiliation: Department of Medicine III, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Graessler
authors.affiliation: Department of Medicine III, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany.
authors.forename: T D
authors.initials: TD
authors.lastname: Bornstein
authors.affiliation: Department of Minimal Access, Bariatric and Surgical Gastroenterology, BLK Super Speciality Hospital, New Delhi, India.
authors.forename: D
authors.initials: D
authors.lastname: Goel
authors.affiliation: Department of Minimal Access, Bariatric and Surgical Gastroenterology, BLK Super Speciality Hospital, New Delhi, India.
authors.forename: V P
authors.initials: VP
authors.lastname: Bhalla
authors.affiliation: Department of Internal Medicine, Dresden Interdisciplinary Adiposity Center, Community Hospital Dresden-Neustadt, Dresden, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Lohmann
authors.affiliation: Department of Internal Medicine, Dresden Interdisciplinary Adiposity Center, Community Hospital Dresden-Neustadt, Dresden, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wolf
authors.affiliation: Department for Visceral, Thoracic and Vascular Surgery, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Koch
authors.affiliation: Research & Cooperation Division, BGI-Shenzhen, Main Building Floor 2, Beishan Industrial Zone, Shenzhen, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Translational Medicine, John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Licinio
authors.affiliation: Department of Translational Medicine, John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: M-L
authors.initials: ML
authors.lastname: Wong
authors.affiliation: Department of Medicine III, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Chavakis
authors.affiliation: Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: A
authors.initials: A
authors.lastname: Xu
authors.affiliation: Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Shevchenko
authors.affiliation: 1] Department of Medicine III, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany [2] Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Schuhmann
authors.affiliation: Department of Medicine III, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany.
authors.forename: P E H
authors.initials: PE
authors.lastname: Schwarz
authors.affiliation: Department of Surgery, King's College Hospital, NHS Foundation Trust, London, UK.
authors.forename: K-M
authors.initials: KM
authors.lastname: Schulte
authors.affiliation: Department of Surgery, King's College Hospital, NHS Foundation Trust, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.affiliation: 1] Department of Medicine III, Carl Gustav Carus Medical School, TU Dresden, Dresden, Germany [2] Department of Endocrinology and Diabetes, King's College, London, UK.
authors.forename: S R
authors.initials: SR
authors.lastname: Bornstein
mesh_terms: D002851:Chromatography, High Pressure Liquid; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D015390:Gastric Bypass; D006801:Humans; D008055:Lipids / Q000097:blood* / Q000145:classification; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000601:surgery*
chemical_list: D008055:Lipids