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de Luis DA, Izaola O, Primo D, López JJ, Pacheco D. A single FTO gene variant rs9939609 is associated with weight change and insulin resistance improvement in response to a robotic sleeve gastrectomy in individuals with severe obesity. Surg Obes Relat Dis 2022; 19:459-465. [PMID: 36509673 DOI: 10.1016/j.soard.2022.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/05/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Genetic mechanisms have been involved in the weight response secondary to bariatric surgery. OBJECTIVE The aim of our study was to evaluate the effects of the rs9939609 genetic variant on weight loss and metabolic parameters after sleeve gastrectomy. SETTING Tertiary hospital. METHODS A total of 95 participants were enrolled. Co-morbidities, biochemical evaluation, and anthropometric parameters were registered before and after 3-, 6-, and 12-month follow-up. Genotype of the rs9939609 fat mass and obesity-associated (FTO) gene was evaluated. RESULTS We grouped the participants into 2 groups: carriers of A allele (TA+AA, 69.5%) and noncarriers of A allele (TT, 30.5%). We detected a statistically significant reduction of blood pressure, biochemical, and anthropometric parameters at 3 times during follow-up. After 6 months, changes of some parameters were greater in non-A allele carriers: weight (-39.6 + 4.0 kg versus -24.6 + 2.8 kg; P = .02), waist circumference (-21.1 + 2.1 cm versus -16.2 + 1.8 cm; P = .04), insulin (-12.3 + .9 mUI/L versus -8.9.1 + .2 mUI/L; P = .02), and homeostasis model assessment of insulin resistance (-3.1 + .1 units versus -2.3 + .1 units; P = .02 ). After 12 months, changes of the aforementioned parameters remained greater in non-A allele carriers. The percentage of participants with diabetes diminished earlier in the non-A allele carriers than A allele carriers at 6-month follow-up. The percentage of participants with diabetes at the end of the study was lower in non-A allele carriers (3.4% versus 12.1%; P = .02). CONCLUSIONS Our data suggest that non-A allele carriers of the genetic variant (rs9939609) of the FTO gene showed a better improvement of anthropometric and insulin levels in non-A allele carriers after a robotic sleeve gastrectomy. Both improvements are associated with a lower percentage of participants with diabetes at 12 months.
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Affiliation(s)
- Daniel Antonio de Luis
- Endocrinology and Nutrition Research Center, School of Medicine, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain.
| | - Olatz Izaola
- Endocrinology and Nutrition Research Center, School of Medicine, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - David Primo
- Endocrinology and Nutrition Research Center, School of Medicine, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Juan José López
- Endocrinology and Nutrition Research Center, School of Medicine, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - David Pacheco
- Endocrinology and Nutrition Research Center, School of Medicine, Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
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Abstract
Metabolomics, or the comprehensive profiling of small molecule metabolites in cells, tissues, or whole organisms, has undergone a rapid technological evolution in the past two decades. These advances have led to the application of metabolomics to defining predictive biomarkers for incident cardiometabolic diseases and, increasingly, as a blueprint for understanding those diseases' pathophysiologic mechanisms. Progress in this area and challenges for the future are reviewed here.
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Affiliation(s)
- Christopher B Newgard
- Sarah W. Stedman Nutrition and Metabolism Center, Duke Molecular Physiology Institute, Departments of Pharmacology & Cancer Biology and Medicine, Duke University Medical Center, Durham, NC 27701, USA.
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de Luis DA, Izaola O, Primo D, Pacheco D. Effect of the rs10767664 Variant of the Brain-Derived Neurotrophic Factor Gene on Weight Change and Cardiovascular Risk Factors in Morbidly Obese Patients after Biliopancreatic Diversion Surgery. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2016; 9:116-122. [DOI: 10.1159/000448102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/30/2016] [Indexed: 11/19/2022]
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Catabolism of Branched Chain Amino Acids Contributes Significantly to Synthesis of Odd-Chain and Even-Chain Fatty Acids in 3T3-L1 Adipocytes. PLoS One 2015; 10:e0145850. [PMID: 26710334 PMCID: PMC4692509 DOI: 10.1371/journal.pone.0145850] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/09/2015] [Indexed: 12/21/2022] Open
Abstract
The branched chain amino acids (BCAA) valine, leucine and isoleucine have been implicated in a number of diseases including obesity, insulin resistance, and type 2 diabetes mellitus, although the mechanisms are still poorly understood. Adipose tissue plays an important role in BCAA homeostasis by actively metabolizing circulating BCAA. In this work, we have investigated the link between BCAA catabolism and fatty acid synthesis in 3T3-L1 adipocytes using parallel 13C-labeling experiments, mass spectrometry and model-based isotopomer data analysis. Specifically, we performed parallel labeling experiments with four fully 13C-labeled tracers, [U-13C]valine, [U-13C]leucine, [U-13C]isoleucine and [U-13C]glutamine. We measured mass isotopomer distributions of fatty acids and intracellular metabolites by GC-MS and analyzed the data using the isotopomer spectral analysis (ISA) framework. We demonstrate that 3T3-L1 adipocytes accumulate significant amounts of even chain length (C14:0, C16:0 and C18:0) and odd chain length (C15:0 and C17:0) fatty acids under standard cell culture conditions. Using a novel GC-MS method, we demonstrate that propionyl-CoA acts as the primer on fatty acid synthase for the production of odd chain fatty acids. BCAA contributed significantly to the production of all fatty acids. Leucine and isoleucine contributed at least 25% to lipogenic acetyl-CoA pool, and valine and isoleucine contributed 100% to lipogenic propionyl-CoA pool. Our results further suggest that low activity of methylmalonyl-CoA mutase and mass action kinetics of propionyl-CoA on fatty acid synthase result in high rates of odd chain fatty acid synthesis in 3T3-L1 cells. Overall, this work provides important new insights into the connection between BCAA catabolism and fatty acid synthesis in adipocytes and underscores the high capacity of adipocytes for metabolizing BCAA.
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The effect of rs9939609 FTO gene polymorphism on weight loss after laparoscopic sleeve gastrectomy. Surg Endosc 2015; 30:121-5. [PMID: 25801113 DOI: 10.1007/s00464-015-4169-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 03/14/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Remarkable differences in weight loss have been observed in obese patients undergoing laparoscopic sleeve gastrectomy (LSG). These high variations might be partly explained by genetic factors. The rs9939609 fat mass and obesity-associated gene (FTO) polymorphism has been implicated in the susceptibility of obesity. We aimed to explore the effects of the rs9939609 FTO gene polymorphism on weight loss among severely obese patients applying for LSG. MATERIALS AND METHODS All individuals were analyzed for the FTO rs9939609 gene polymorphism. A total of 74 morbid obese patients (20 male, 54 female) were operated. Body weight and body mass index (BMI) were measured at before LSG and after surgery at the sixth month. RESULTS Twenty-eight patients (37.8%) had genotype TT (wild-type allel), 36 patients (48.6%) had genotype TA, and 10 patients (13.5%) had genotype AA. In both wild-type group and mutant group, BMI and weight levels decreased at the sixth month after surgery. Percent of excess weight loss (EWL) at 6 months of follow-up was similar in both groups. There were no differences between the mutant and wild-type groups percent of EWL at the sixth month after applying LSG. CONCLUSION Our data showed that the rs9939609 FTO gene polymorphism is not a useful genetic test prior to LSG to help clinicians predicting the weight loss for severely obese patients in short-term follow-up.
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de Luis DA, Pacheco D, Aller R, Izaola O. Role of the rs6923761 gene variant in glucagon-like peptide 1 receptor gene on cardiovascular risk factors and weight loss after biliopancreatic diversion surgery. ANNALS OF NUTRITION AND METABOLISM 2014; 65:259-63. [PMID: 25376673 DOI: 10.1159/000365975] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/17/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies of the glucagon-like peptide 1 (GLP-1) receptor (GLP-1R) have been directed at identifying polymorphisms in the GLP-1R gene that may be a contributing factor in the pathogenesis of obesity. OBJECTIVE We decided to investigate the role of the rs6923761 GLP-1R polymorphism on outcomes after biliopancreatic diversion. DESIGN A sample of 137 morbidly obese patients was operated. Weight, blood pressure, basal glucose and lipid profile were measured at the basal visit and at each following visit (basal, 3, 9, 12 and 18 months). RESULTS Body mass index, weight and waist circumference were lower in non-A allele carriers than A allele carriers 12 and 18 months after surgery. The initial weight percent loss at 12 months (45.6 vs. 39.8%; p < 0.05) or 18 months (49.6 vs. 41.3%; p < 0.05) was higher in patients with GG genotype than A allele carriers. CONCLUSION Our study showed a higher weight loss 12 and 18 months after bariatric surgery in GG variant than A allele carriers. The biochemical parameters and cardiovascular comorbidity rates improved similarly in both genotypes.
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Affiliation(s)
- Daniel Antonio de Luis
- Center of Investigation of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
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Shah SH, Kraus WE, Newgard CB. Metabolomic profiling for the identification of novel biomarkers and mechanisms related to common cardiovascular diseases: form and function. Circulation 2012; 126:1110-20. [PMID: 22927473 DOI: 10.1161/circulationaha.111.060368] [Citation(s) in RCA: 267] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Svati H Shah
- Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Duke Independence Park Facility, 4321 Medical Park Drive, Durham, NC 27704, USA.
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Erickson LC, Scott-Van Zeeland AA, Hamilton G, Lincoln A, Golomb BA. Brief report: approaches to 31P-MRS in awake, non-sedated children with and without autism spectrum disorder. J Autism Dev Disord 2012; 42:1120-6. [PMID: 21979108 DOI: 10.1007/s10803-011-1359-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We piloted a suite of approaches aimed to facilitate a successful series of up to four brain and muscle (31)Phosphorus-Magnetic Resonance Spectroscopy ((31)P-MRS) scans performed in one session in 12 awake, non-sedated subjects (ages 6-18), 6 with autism spectrum disorders (ASD) and 6 controls. We targeted advanced preparation, parental input, physical comfort, short scan protocols, allocation of extra time, and subject emotional support. 100% of subjects completed at least one brain scan and one leg muscle scan: 42 of 46 attempted scans were completed (91%), with failures dominated by exercise muscle scans (completed in 6/6 controls but 3/6 cases). One completed scan lacked usable data unrelated to subject/scan procedure (orthodonture affected a frontal brain scan). As a group, these methods provide a foundation for conduct and enhancement of future MR studies in pediatric subjects with ASD.
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Affiliation(s)
- Laura C Erickson
- Department of Medicine, University of California, San Diego, 9500 Gilman Dr #0995, La Jolla, CA 92093-0995, USA
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de Luis DA, Aller R, Conde R, Izaola O, Pacheco D, Sagrado MG, Primo D. Effects of RS9939609 gene variant in FTO gene on weight loss and cardiovascular risk factors after biliopancreatic diversion surgery. J Gastrointest Surg 2012; 16:1194-8. [PMID: 22311283 DOI: 10.1007/s11605-012-1829-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 01/19/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND The high variation in responses to bariatric surgery might be partially explained by genetic effects. Recently, common polymorphisms of the fat mass and obesity-associated gene (FTO) have been linked to obesity in some populations. Only two studies have investigated the effect of FTO variants on weight loss of morbid obese patients undergoing bariatric surgery with contradictory results. OBJECTIVE We decided to investigate the role of the rs9939609 FTO gene polymorphism on outcomes after a biliopancreatic diversion surgery (BPD) in morbidly obese patients. DESIGN A sample of 119 morbidly obese patients' body mass index (BMI) > 40 kg/m(2) were operated. Weight, fat mass, blood pressure, basal glucose, triacylglycerols, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol were measured at basal visit and at each visit (basal, 3, 9 and 12 months). The frequency of metabolic comorbidities was recorded at each visit. RESULTS Thirty-seven patients (31.1%) had genotype TT (wild type group), 58 (48.7%) patients had genotype TA and 24 patients (20.2%) had genotype AA. In the wild and mutant type groups, BMI, weight, waist circumference, systolic blood pressure and diastolic blood pressure decreased in a significant way. In the wild type groups, glucose, total cholesterol, low density lipoprotein (LDL) cholesterol and triacylglycerol concentrations decreased at 3, 9 and 12 months after surgery. In the mutant type groups, glucose, total cholesterol and triacylglycerol concentrations decreased at 3, 9 and 12 months after surgery. LDL cholesterol decreased at 9 and 12 months after surgery. Initial weight percent loss at 3 months of follow-up was higher in the wild type group (26.1% vs. 18.6%: p < 0.05). The initial weight percent loss at 9 or 12 months was similar in both genotypes. CONCLUSION Our study showed a higher initial weight loss at 3 months after the TT variant of FTO gene (rs9939609). However, the weight loss at 9 and 12 months of BPD was similar in both genotypes with a significant improvement in biochemical parameters and cardiovascular comorbidities.
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Affiliation(s)
- Daniel Antonio de Luis
- Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation. Hospital Rio Hortega, University of Valladolid, Valladolid, Spain.
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Newgard CB. Interplay between lipids and branched-chain amino acids in development of insulin resistance. Cell Metab 2012; 15:606-14. [PMID: 22560213 PMCID: PMC3695706 DOI: 10.1016/j.cmet.2012.01.024] [Citation(s) in RCA: 765] [Impact Index Per Article: 63.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Revised: 12/10/2011] [Accepted: 01/11/2012] [Indexed: 12/12/2022]
Abstract
Fatty acids (FA) and FA-derived metabolites have long been implicated in the development of insulin resistance and type 2 diabetes. Surprisingly, application of metabolomics technologies has revealed that branched-chain amino acids (BCAA) and related metabolites are more strongly associated with insulin resistance than many common lipid species. Moreover, the BCAA-related signature is predictive of incident diabetes and intervention outcomes and uniquely responsive to therapeutic interventions. Nevertheless, in animal feeding studies, BCAA supplementation requires the background of a high-fat diet to promote insulin resistance. This Perspective develops a model to explain how lipids and BCAA may synergize to promote metabolic diseases.
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Affiliation(s)
- Christopher B Newgard
- Sarah W. Stedman Nutrition and Metabolism Center, Department of Pharmacology, Duke University Medical Center, Durham, NC 27704, USA.
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Liou TH, Chen HH, Wang W, Wu SF, Lee YC, Yang WS, Lee WJ. ESR1, FTO, and UCP2 genes interact with bariatric surgery affecting weight loss and glycemic control in severely obese patients. Obes Surg 2012; 21:1758-65. [PMID: 21720911 DOI: 10.1007/s11695-011-0457-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Significant variability in weight loss and glycemic control has been observed in obese patients receiving bariatric surgery. Genetic factors may play a role in the different outcomes. METHODS Five hundred and twenty severely obese patients with body mass index (BMI) ≥35 were recruited. Among them, 149 and 371 subjects received laparoscopic adjustable gastric banding (LAGB) and laparoscopic mini-gastric bypass (LMGB), respectively. All individuals were genotyped for five obesity-related single nucleotide polymorphisms on ESR1, FTO, PPARγ, and UCP2 genes to explore how these genes affect weight loss and glycemic control after bariatric surgery at the 6th month. RESULTS Obese patients with risk genotypes on rs660339-UCP2 had greater decrease in BMI after LAGB compared to patients with non-risk genotypes (-7.5 vs. -6 U, p = 0.02). In contrast, after LMGB, obese patients with risk genotypes on either rs712221-ESR1 or rs9939609-FTO had significant decreases in BMI (risk vs. non-risk genotype, -12.5 vs. -10.0 U on rs712221, p = 0.02 and -12.1 vs. -10.6 U on rs9939609, p = 0.04) and a significant amelioration in HbA1c levels (p = 0.038 for rs712221 and p < 0.0001 for rs9939609). The synergic effect of ESR1 and FTO genes on HbA1c amelioration was greater (-1.54%, p for trend <0.001) than any of these genes alone in obese patients receiving LMGB. CONCLUSIONS The genetic variants in the ESR, FTO, and UCP2 genes may be considered as a screening tool prior to bariatric surgery to help clinicians predict weight loss or glycemic control outcomes for severely obese patients.
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Affiliation(s)
- Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Kalra SP. Pivotal role of leptin-hypothalamus signaling in the etiology of diabetes uncovered by gene therapy: a new therapeutic intervention? Gene Ther 2011; 18:319-25. [PMID: 21209624 DOI: 10.1038/gt.2010.164] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The incidence of diabetes mellitus has soared to epidemic proportion worldwide. The debilitating chronic hyperglycemia is caused by either lack of insulin as in diabetes type 1 or its ineffectiveness as in diabetes type 2. Frequent replacement of insulin with or without insulin analogs for optimum glycemic control are the conventional cumbersome therapies. Recent application of leptin gene transfer technology has uncovered the participation of adipocytes-derived leptin-dependent hypothalamic neural signaling in glucose homeostasis and demonstrated that a breakdown in this communication due to leptin insufficiency in the hypothalamus underlies the etiology of chronic hyperglycemia. Reinstatement of central leptin sufficiency by hyperleptinemia produced either by intravenous leptin infusion or a single systemic injection of recombinant adenovirus vector encoding leptin gene suppressed hyperglycemia and evoked euglycemia only transiently in rodent models of diabetes type 1. In contrast, stable restoration of leptin sufficiency, solely in the hypothalamus, with biologically active leptin transduced by an intracerebroventicular injection of recombinant adeno-associated virus vector encoding leptin gene (rAAV-lep) abolished hyperglycemia and imposed euglycemia through the extended duration of experiment by stimulating glucose disposal in the periphery in models of diabetes type 1. Further, similar hypothalamic leptin transgene expression abrogated chronic hyperglycemia and hyperinsulinemia, the predisposing risk factors of the age and environmentally acquired diabetes type 2, and instituted euglycemia by independently activating relays that stimulate glucose metabolism and repress hyperinsulinemia and improve insulin sensitivity in the periphery. Consequently, this durable antidiabetic efficacy of one time rAAV-lep neurotherapy offers a potential novel substitute for insulin therapy following preclinical trials in subhuman primates and humans.
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Affiliation(s)
- S P Kalra
- Department of Neuroscience, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL 32610-0244, USA.
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