title: Facilitated long chain fatty acid uptake by adipocytes remains upregulated relative to BMI for more than a year after major bariatric surgical weight loss.
abstract: OBJECTIVE
  This study examined whether changes in adipocyte long chain fatty acid (LCFA) uptake kinetics explain the weight regain increasingly observed following bariatric surgery.
  
  
  METHODS
  Three groups (10 patients each) were studied: patients without obesity (NO: BMI 24.2 ± 2.3 kg m(-2) ); patients with obesity (O: BMI 49.8 ± 11.9); and patients classified as super-obese (SO: BMI 62.6 ± 2.8). NO patients underwent omental and subcutaneous fat biopsies during clinically indicated abdominal surgeries; O were biopsied during bariatric surgery, and SO during both a sleeve gastrectomy and at another bariatric operation 16 ± 2 months later, after losing 113 ± 13 lbs. Adipocyte sizes and [(3) H]-LCFA uptake kinetics were determined in all biopsies.
  
  
  RESULTS
  Vmax for facilitated LCFA uptake by omental adipocytes increased exponentially from 5.1 ± 0.95 to 21.3 ± 3.20 to 68.7 ± 9.45 pmol/sec/50,000 cells in NO, O, and SO patients, respectively, correlating with BMI (r = 0.99, P < 0.001). Subcutaneous results were virtually identical. By the second operation, the mean BMI (SO patients) fell significantly (P < 0.01) to 44.4 ± 2.4 kg m(-2) , similar to the O group. However, Vmax (40.6 ± 11.5) in this weight-reduced group remained ~2X that predicted from the BMI:Vmax regression among NO, O, and SO patients.
  
  
  CONCLUSIONS
  Facilitated adipocyte LCFA uptake remains significantly upregulated ≥1 year after bariatric surgery, possibly contributing to weight regain.
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: Fengxia
authors.initials: F
authors.lastname: Ge
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: José L
authors.initials: JL
authors.lastname: Walewski
authors.affiliation: Department of Surgery, Weill-Cornell Medical Center, New York, New York, USA.
authors.forename: Mehyar Hefazi
authors.initials: MH
authors.lastname: Torghabeh
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: Harrison
authors.initials: H
authors.lastname: Lobdell
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: Chunguang
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: Shengli
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Surgery, Weill-Cornell Medical Center, New York, New York, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dakin
authors.affiliation: Department of Surgery, Weill-Cornell Medical Center, New York, New York, USA.
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, New York, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Bessler
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, New York, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Schrope
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, New York, USA.
authors.forename: Aku
authors.initials: A
authors.lastname: Ude-Welcome
authors.affiliation: Department of Surgery, Mount Sinai Beth Israel Medical Center, New York, New York, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Inabnet
authors.affiliation: Department of Psychiatry, Division of Biostatistics, Columbia University Medical Center, New York, New York, USA.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Feng
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: Elektra
authors.initials: E
authors.lastname: Carras-Terzian
authors.affiliation: Department of Medicine, Division of Digestive & Liver Disease, Columbia University Medical Center, New York, New York, USA.
authors.forename: Dieunine
authors.initials: D
authors.lastname: Anglade
authors.affiliation: Department of Surgery, Weill-Cornell Medical Center, New York, New York, USA.
authors.forename: Faith E
authors.initials: FE
authors.lastname: Ebel
authors.affiliation: Department of Medicine, Divisions of Digestive & Liver Disease and Preventive Medicine, Columbia University Medical Center, New York, New York, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Berk
mesh_terms: D017667:Adipocytes / Q000378:metabolism* / Q000473:pathology; D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D005227:Fatty Acids / Q000493:pharmacokinetics*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D009852:Omentum / Q000378:metabolism / Q000473:pathology; D050151:Subcutaneous Fat / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D015854:Up-Regulation; D015431:Weight Loss / Q000502:physiology*
chemical_list: D005227:Fatty Acids