title: Metabolomics-guided insights on bariatric surgery versus behavioral interventions for weight loss.
abstract: OBJECTIVE
  To review the metabolomic studies carried out so far to identify metabolic markers associated with surgical and dietary treatments for weight loss in subjects with obesity.
  
  
  METHODS
  The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
  
  
  RESULTS
  Thirty-two studies successfully met the eligibility criteria. The metabolic adaptations shared by surgical and dietary interventions mirrored a state of starvation ketoacidosis (increase of circulating ketone bodies), an increase of acylcarnitines and fatty acid β-oxidation, a decrease of specific amino acids including branched-chain amino acids (BCAA) and (lyso)glycerophospholipids previously associated with obesity, and adipose tissue expansion. The metabolic footprint of bariatric procedures was specifically characterized by an increase of bile acid circulating pools and a decrease of ceramide levels, a greater perioperative decline in BCAA, and the rise of circulating serine and glycine, mirroring glycemic control and inflammation improvement. In one study, 3-hydroxybutyrate was particularly identified as an early metabolic marker of long-term prognosis after surgery and proposed to increase current prognostic modalities and contribute to personalized treatment.
  
  
  CONCLUSIONS
  Metabolomics helped in deciphering the metabolic response to weight loss treatments. Moving from association to causation is the next challenge to move to a further level of clinical application.
authors.affiliation: Department of Nutrition, Food Sciences and Gastronomy, Biomarkers & Nutrimetabolomic Lab, XaRTA, INSA, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.|Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex (Virgen de la Victoria), University of Malaga, Malaga, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Tulipani
authors.affiliation: MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.|Department of Biochemistry and the Cambridge Systems Biology Centre, University of Cambridge, Cambridge, UK.
authors.forename: Jules
authors.initials: J
authors.lastname: Griffin
authors.affiliation: Department of Nutrition, Food Sciences and Gastronomy, Biomarkers & Nutrimetabolomic Lab, XaRTA, INSA, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
authors.forename: Magali
authors.initials: M
authors.lastname: Palau-Rodriguez
authors.affiliation: Department of Nutrition, Food Sciences and Gastronomy, Biomarkers & Nutrimetabolomic Lab, XaRTA, INSA, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
authors.forename: Ximena
authors.initials: X
authors.lastname: Mora-Cubillos
authors.affiliation: Biomedical Research Institute (IBIMA), Service of Internal Medicine, Malaga Hospital Complex (Hospital Regional Universitario de Malaga), University of Malaga, Malaga, Spain.|CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Bernal-Lopez
authors.affiliation: Biomedical Research Institute (IBIMA), Service of Endocrinology and Nutrition, Malaga Hospital Complex (Virgen de la Victoria), University of Malaga, Malaga, Spain.|CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tinahones
authors.affiliation: School of Medicine, Obesity Research Center, Boston University, Boston, Massachusetts, USA.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Corkey
authors.affiliation: Department of Nutrition, Food Sciences and Gastronomy, Biomarkers & Nutrimetabolomic Lab, XaRTA, INSA, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Andres-Lacueva
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood; D000273:Adipose Tissue / Q000378:metabolism; D000597:Amino Acids, Branched-Chain / Q000097:blood; D050110:Bariatric Surgery; D001521:Behavior Therapy; D001647:Bile Acids and Salts / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D004032:Diet; D006801:Humans; D008297:Male; D055432:Metabolomics; D009765:Obesity / Q000378:metabolism / Q000628:therapy*; D015431:Weight Loss
chemical_list: D000597:Amino Acids, Branched-Chain; D001647:Bile Acids and Salts; D001786:Blood Glucose; D020155:3-Hydroxybutyric Acid