PMID- 32564307 OWN - NLM STAT- MEDLINE DCOM- 20210414 LR - 20210414 IS - 1708-0428 (Electronic) IS - 0960-8923 (Linking) VI - 30 IP - 10 DP - 2020 Oct TI - Different Malabsorptive Obesity Surgery Interventions Result in Distinct Postprandial Amino Acid Metabolomic Signatures. PG - 4019-4028 LID - 10.1007/s11695-020-04774-z [doi] AB - PURPOSE: Biliopancreatic diversion with duodenal switch (BPD-DS) is an effective weight loss surgical procedure. Yet, BPD-DS is technically difficult to perform and carries a higher risk of nutrient deficiencies as compared with other surgical interventions. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a modified BPD-DS procedure conceived with the aim of decreasing the technical complexity, while retaining the weight loss efficiency. Whether the two surgical procedures diverge in nutrient absorption rates and malnutrition risk is still matter of debate. Our aim was to determine if postprandial nutrient absorption rates are different in patients subjected to BPD-DS or SADI-S for weight loss. MATERIALS AND METHODS: Plasma amino acid metabolomic profiling during mixed-meal tolerance test (MMTT) was performed in subjects (N = 18) submitted to BPD-DS (n = 9) or SADI-S (n = 9) 1.6 +/- 0.1 years earlier. RESULTS: Patients submitted to SADI-S or BPD-DS presented distinct postprandial metabolomic profiles. Postprandial excursions of total and essential amino acids-leucine, isoleucine, and valine-were higher after SADI-S as compared with BPD-DS. CONCLUSION: Our study demonstrates that a simplified malabsorptive bariatric surgery procedure SADI-S results in greater essential branched-chain amino acid absorption when compared with the classical BPD-DS intervention. These findings suggest that SADI-S can potentially lower lifetime risk of postoperative protein malnutrition, as well as have a positive impact on systemic metabolism and glucose homeostasis. FAU - Pereira, Sofia S AU - Pereira SS AD - Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. AD - Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal. AD - Instituto de Investigacao e Inovacao em Saude (I3S), Universidade do Porto, Porto, Portugal. AD - Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal. FAU - Jarak, Ivana AU - Jarak I AD - Department of Microscopy, Laboratory of Cell Biology and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal. FAU - Carvalho, Rui A AU - Carvalho RA AD - Department of Life Sciences, Faculty of Science and Technology (FCTUC), University of Coimbra, Coimbra, Portugal. FAU - Oliveira, Pedro F AU - Oliveira PF AD - QOPNA & LAQV, Department of Chemistry, University of Aveiro, Aveiro, Portugal. FAU - Alves, Marco G AU - Alves MG AD - Department of Microscopy, Laboratory of Cell Biology and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal. FAU - Guimaraes, Marta AU - Guimaraes M AD - Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. AD - Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal. AD - Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. FAU - Almeida, Rui AU - Almeida R AD - Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. FAU - Pereira, Ana M AU - Pereira AM AD - Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. FAU - Wewer Albrechtsen, Nicolai J AU - Wewer Albrechtsen NJ AD - Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. AD - Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2100, Copenhagen, Denmark. AD - Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark. FAU - Holst, Jens J AU - Holst JJ AD - Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. AD - Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2100, Copenhagen, Denmark. FAU - Nora, Mario AU - Nora M AD - Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. FAU - Monteiro, Mariana P AU - Monteiro MP AUID- ORCID: 0000-0002-0662-1831 AD - Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal. mpmonteiro@icbas.up.pt. AD - Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal. mpmonteiro@icbas.up.pt. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200620 PL - United States TA - Obes Surg JT - Obesity surgery JID - 9106714 RN - 0 (Amino Acids) SB - IM MH - Amino Acids MH - *Bariatric Surgery MH - *Biliopancreatic Diversion MH - Duodenum MH - Gastrectomy MH - Humans MH - *Obesity, Morbid/surgery OTO - NOTNLM OT - Amino acid absorption OT - BPD-DS OT - Malabsorptive bariatric surgeries OT - Metabolomics OT - SADI-S EDAT- 2020/06/22 06:00 MHDA- 2021/04/15 06:00 CRDT- 2020/06/22 06:00 PHST- 2020/04/02 00:00 [received] PHST- 2020/06/05 00:00 [accepted] PHST- 2020/06/05 00:00 [revised] PHST- 2020/06/22 06:00 [pubmed] PHST- 2021/04/15 06:00 [medline] PHST- 2020/06/22 06:00 [entrez] AID - 10.1007/s11695-020-04774-z [pii] AID - 10.1007/s11695-020-04774-z [doi] PST - ppublish SO - Obes Surg. 2020 Oct;30(10):4019-4028. doi: 10.1007/s11695-020-04774-z. Epub 2020 Jun 20.