PMID- 36792463 OWN - NLM STAT- MEDLINE DCOM- 20230501 LR - 20230501 IS - 1871-403X (Print) IS - 1871-403X (Linking) VI - 17 IP - 2 DP - 2023 Mar-Apr TI - Are SADI-S and BPD/DS bariatric procedures identical twins or distant relatives? - A case report. PG - 166-170 LID - S1871-403X(23)00013-3 [pii] LID - 10.1016/j.orcp.2023.02.004 [doi] AB - Given the common anatomical features and similar short-term weight loss outcomes, Biliopancreatic Diversion with Duodenal Switch (BPD/DS) and Single-Anastomosis Duodenoileal bypass with Sleeve gastrectomy (SADI-S) are considered identical bariatric procedures, apart from technical complexity being lower for SADI-S. In the absence of prospective randomized trials or long-term comparative studies the rationale for choosing between procedures is hampered. Post-bariatric hormonal profiles could contribute to understand the underlying mechanisms and potentially be used as a decision aid when choosing between procedures. The main aim of this study was to compare the outcomes of BPD/DS and SADI-S, in genetically identical individuals exposed to similar environmental factors. Two identical twin (T) female patients, one submitted to BPD/DS (T_BPD/DS) and another to SADIS-S (T_SADI-S) were followed up to one year after surgery. Before surgery and at 3, 6 and 12 months after surgery, both patients underwent mixed meal tolerance tests (MMTT) to evaluate postprandial glucose, glucagon and GLP-1 response. In addition, 3 months after surgery, glucose dynamics were assessed using a Flash Glucose Monitoring (FGM) system for 14 days. The percentage of total weight loss (%TWL) was higher for T_BPD/DS compared to T_SADI-S (34.03 vs 29.03 %). During MMTT, T_BPD/DS presented lower glucose, glucagon, insulin and C-peptide excursions at all timepoints when compared to SADI-S; along with a greater percentage of time within the low glucose range (55.97 vs 39.93 %) and numerically lower glucose variability indexes on FGM (MAG change:0.51 vs 0.63 mmol/lxh(-1)). In patients with the same genetic background, BPD/DS was shown to result in greater weight loss than SADI-S. The differences in glucose and enteropancreatic hormone profiles observed after BPD/DS and SADI-S suggest that different mechanisms underlie weight loss. CI - Copyright (c) 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Guimaraes, Marta AU - Guimaraes M AD - Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal; UMIB - Unidade Multidisciplinar de Investigacao Biomedica, ICBAS - Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Portugal. FAU - Pereira, Ana Marta AU - Pereira AM AD - Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal. FAU - Pereira, Sofia S AU - Pereira SS AD - UMIB - Unidade Multidisciplinar de Investigacao Biomedica, ICBAS - Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, 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 - Lobato, Carolina B AU - Lobato CB AD - UMIB - Unidade Multidisciplinar de Investigacao Biomedica, ICBAS - Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Portugal; Department of Biomedical Sciences and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology, Copenhagen University Hvidovre Hospital, Hvidovre, Denmark. FAU - Hartmann, Bolette AU - Hartmann B AD - Department of Biomedical Sciences and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. FAU - Holst, Jens J AU - Holst JJ AD - Department of Biomedical Sciences and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 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; UMIB - Unidade Multidisciplinar de Investigacao Biomedica, ICBAS - Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Portugal. FAU - Monteiro, Mariana P AU - Monteiro MP AD - UMIB - Unidade Multidisciplinar de Investigacao Biomedica, ICBAS - Instituto de Ciencias Biomedicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Portugal. Electronic address: mpmonteiro@icbas.up.pt. LA - eng PT - Case Reports PT - Research Support, Non-U.S. Gov't DEP - 20230213 PL - Netherlands TA - Obes Res Clin Pract JT - Obesity research & clinical practice JID - 101303911 RN - 9007-92-5 (Glucagon) RN - 0 (Blood Glucose) RN - IY9XDZ35W2 (Glucose) SB - IM MH - Humans MH - Female MH - *Biliopancreatic Diversion/methods MH - *Obesity, Morbid/surgery MH - Glucagon MH - Blood Glucose Self-Monitoring MH - Prospective Studies MH - Twins, Monozygotic MH - Blood Glucose MH - *Gastric Bypass/methods MH - *Bariatrics MH - Duodenum/surgery MH - Gastrectomy/methods MH - Glucose MH - Weight Loss/physiology MH - Retrospective Studies OTO - NOTNLM OT - BPD/DS OT - Case report OT - Enteropancreatic hormone profile OT - SADI-S OT - Twins COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/02/16 06:00 MHDA- 2023/05/01 06:41 CRDT- 2023/02/15 22:01 PHST- 2023/01/10 00:00 [received] PHST- 2023/01/31 00:00 [revised] PHST- 2023/02/10 00:00 [accepted] PHST- 2023/05/01 06:41 [medline] PHST- 2023/02/16 06:00 [pubmed] PHST- 2023/02/15 22:01 [entrez] AID - S1871-403X(23)00013-3 [pii] AID - 10.1016/j.orcp.2023.02.004 [doi] PST - ppublish SO - Obes Res Clin Pract. 2023 Mar-Apr;17(2):166-170. doi: 10.1016/j.orcp.2023.02.004. Epub 2023 Feb 13.