Prediction of glycated hemoglobin levels at 3 months after metabolic surgery based on the 7-day plasma metabolic profile.
Metabolic surgery has been shown to provide better glycemic control for type 2 diabetes than conventional therapies. Still, the outcomes of the surgery are variable, and prognostic markers reflecting the metabolic changes by the surgery are yet to be established. NMR-based plasma metabolomics followed by multivariate regression was used to test the correlation between the metabolomic profile at 7-days after surgery and glycated hemoglobin (HbA1c) levels at 3-months (and up to 12 months with less patients), and to identify the relevant markers. Metabolomic profiles at 7-days could differentiate the patients according to the HbA1c improvement status at 3-months. The HbA1c values were predicted based on the metabolomics profile with partial least square regression, and found to be correlated with the observed values. Metabolite analysis suggested that 3-Hydroxybutyrate (3-HB) and glucose contributes to this prediction, and the [3-HB]/[glucose] exhibited a modest to good correlation with the HbA1c level at 3-months. The prediction of 3-month HbA1c using 7-day metabolomic profile and the suggested new criterion [3-HB]/[glucose] could augment current prognostic modalities and help clinicians decide if drug therapy is necessary.
College of Pharmacy, Natural Product Research Institute, Seoul National University, Sillim-dong, Gwanak-gu, Seoul, Korea, 151-742.
Hyuk Nam
HN
Kwon
Department of Family Medicine, Obesity center, Inha University Hospital, Inha University School of Medicine, Shinheung-dong, Jung-Gu, Incheon, Korea, 400-712.
Yeon Ji
YJ
Lee
Department of Pharmacology and Hypoxia-related disease Research, Inha University Hospital, Inha University School of Medicine, Shinheung-dong, Jung-Gu, Incheon, Korea, 400-712.
Ju-Hee
JH
Kang
Department of Family Medicine, Obesity center, Inha University Hospital, Inha University School of Medicine, Shinheung-dong, Jung-Gu, Incheon, Korea, 400-712.
Ji-Ho
JH
Choi
College of Pharmacy, Natural Product Research Institute, Seoul National University, Sillim-dong, Gwanak-gu, Seoul, Korea, 151-742.
Yong Jin
YJ
An
College of Pharmacy, Natural Product Research Institute, Seoul National University, Sillim-dong, Gwanak-gu, Seoul, Korea, 151-742.
Sunmi
S
Kang
Department of Medicine, Inha University Hospital, Inha University School of Medicine, Shinheung-dong, Jung-Gu, Incheon, Korea, 400-712.
Dae Hyun
DH
Lee
Department of Biostatistics, Inha University Hospital, Inha University School of Medicine, Shinheung-dong, Jung-Gu, Incheon, Korea, 400-712.
Young Ju
YJ
Suh
Department of General Surgery, Inha University Hospital, Inha University School of Medicine, Shinheung-dong, Jung-Gu, Incheon, Korea, 400-712.
Yoonseok
Y
Heo
College of Pharmacy, Natural Product Research Institute, Seoul National University, Sillim-dong, Gwanak-gu, Seoul, Korea, 151-742.
Sunghyouk
S
Park
D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D006442:Glycated Hemoglobin / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D016018:Least-Squares Analysis; D009682:Magnetic Resonance Spectroscopy; D055432:Metabolomics / Q000379:methods; D008954:Models, Biological; D011379:Prognosis; D056910:Republic of Korea; D013997:Time Factors
D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human