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Bialobroda J, Bouazizi K, Zarai M, Kachenoura N, Clement K, Aron-Wisnewsky J, Hatem S, Redheuil A. Epicardial adipose tissue of atrioventricular grooves is a reliable and early MRI biomarker of the effect of metabolic diseases on atrial myocardium. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Epicardial adipose tissue (EAT), the visceral adipose tissue surrounding the heart, is implicated in a host of cardiovascular diseases playing a transducer role between systemic metabolic conditions and the myocardium, as illustrated by higher risk of atrial fibrillation in patients with diabetes or obesity. MRI affords comprehensive and non-invasive insights into myocardial structure, function and tissue properties. However, the clinical usefulness of whole atrial EAT is limited by its challenging measurability in clinical routine in several imaging modalities, including MRI.
Purpose
We hypothesized that atrioventricular groove epicardial adipose tissue (GEAT) which can be measured routinely based on established anatomic landmarks may be: 1) a relevant surrogate of atrial EAT and 2) a relevant imaging biomarker to characterize atrial alterations in patients with varied degrees of metabolic disorders.
Methods
Ninety-nine patients from the METACARDIS cohort (EU FP7) who had MRI, all in sinus rhythm and without overt clinical heart disease, were divided into 4 groups based on distinct metabolic profiles: metabolic syndrome (MS, n=24), severe obesity (SO, BMI ≥35 kg/m2, n=17), type-2 diabetes (T2D, n=41) and healthy controls (n=17). Atrioventricular groove EAT volume was measured from cine SSFP MRI images in four-, three-, two-chamber and short-axis views; atrial EAT volume was measured from four- and two-chamber views. Native T1-mapping values of EAT at the anterior atrioventricular groove excluding the coronary vessels were measured from the MOLLI sequence (basal short-axis slice).
Results
We found a high correlation between GEAT and atrial EAT volumes (r=0.96; p<0.0001) indicating that GEAT may reflect global atrial EAT volume. Next, we compared GEAT volume across study groups and found an increased GEAT volume in the 3 groups of patients with metabolic diseases compared to controls, with a significantly higher volume in MS (4.7±1.5 ml), SO (4.1±1.2 ml), and T2D (3.7±1.1 ml) than in Controls (2.6±0.6 ml; p≤0.001, p≤0.01, p≤0.05, respectively). In addition, T2D patients had lower native T1 values within GEAT compared to healthy controls (250±26 ms versus 280±31 ms; p≤0.01).
Conclusion
Atrioventricular groove EAT can be easily measured from conventional cine SSFP MRI images and could be used as a surrogate of global atrial EAT. Both volume and properties of GEAT are related to the metabolic status of patients. Furthermore, given its pure epicardial origin and pericoronary distribution, GEAT appears as a relevant biomarker of metabolic impacts on atrial myocardium.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Annee-recherche, Agence Regionale de Sante Ile-de-France
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Affiliation(s)
- J Bialobroda
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM UMRS1166, Sorbonne University, Institute of Cardiology, Pitié-Salpêtrière Hospital , Paris , France
| | - K Bouazizi
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM, Sorbonne University, Imaging Core Lab, Pitié-Salpêtrière Hospital , Paris , France
| | - M Zarai
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM, Sorbonne University, Imaging Core Lab, Pitié-Salpêtrière Hospital , Paris , France
| | - N Kachenoura
- Sorbonne University, Biomedical Imaging Laboratory, CNRS, INSERM , Paris , France
| | - K Clement
- Pitie Salpetriere APHP University Hospital, Nutrition Department, CRNH Ile de France , Paris , France
| | - J Aron-Wisnewsky
- Pitie Salpetriere APHP University Hospital, Nutrition Department, CRNH Ile de France , Paris , France
| | - S Hatem
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM UMRS1166, Sorbonne University, Institute of Cardiology, Pitié-Salpêtrière Hospital , Paris , France
| | - A Redheuil
- Institute of Cardiometabolism and Nutrition - ICAN, INSERM, Sorbonne University, Imaging Core Lab, Pitié-Salpêtrière Hospital , Paris , France
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2
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Pellegrinelli V, Rodriguez-Cuenca S, Rouault C, Figueroa-Juarez E, Schilbert H, Virtue S, Moreno-Navarrete JM, Bidault G, Vázquez-Borrego MC, Dias AR, Pucker B, Dale M, Campbell M, Carobbio S, Lin YH, Vacca M, Aron-Wisnewsky J, Mora S, Masiero MM, Emmanouilidou A, Mukhopadhyay S, Dougan G, den Hoed M, Loos RJF, Fernández-Real JM, Chiarugi D, Clément K, Vidal-Puig A. Dysregulation of macrophage PEPD in obesity determines adipose tissue fibro-inflammation and insulin resistance. Nat Metab 2022; 4:476-494. [PMID: 35478031 DOI: 10.1038/s42255-022-00561-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/18/2022] [Indexed: 02/02/2023]
Abstract
Resulting from impaired collagen turnover, fibrosis is a hallmark of adipose tissue (AT) dysfunction and obesity-associated insulin resistance (IR). Prolidase, also known as peptidase D (PEPD), plays a vital role in collagen turnover by degrading proline-containing dipeptides but its specific functional relevance in AT is unknown. Here we show that in human and mouse obesity, PEPD expression and activity decrease in AT, and PEPD is released into the systemic circulation, which promotes fibrosis and AT IR. Loss of the enzymatic function of PEPD by genetic ablation or pharmacological inhibition causes AT fibrosis in mice. In addition to its intracellular enzymatic role, secreted extracellular PEPD protein enhances macrophage and adipocyte fibro-inflammatory responses via EGFR signalling, thereby promoting AT fibrosis and IR. We further show that decreased prolidase activity is coupled with increased systemic levels of PEPD that act as a pathogenic trigger of AT fibrosis and IR. Thus, PEPD produced by macrophages might serve as a biomarker of AT fibro-inflammation and could represent a therapeutic target for AT fibrosis and obesity-associated IR and type 2 diabetes.
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Affiliation(s)
- V Pellegrinelli
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.
| | - S Rodriguez-Cuenca
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, P. R. China
| | - C Rouault
- Sorbonne University, INSERM, NutriOmique Research Unit, Paris, France
| | - E Figueroa-Juarez
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - H Schilbert
- Genetics and Genomics of Plants, Centre for Biotechnology (CeBiTec) & Faculty of Biology, Bielefeld University, Bielefeld, Germany
| | - S Virtue
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - J M Moreno-Navarrete
- Department of Diabetes, Endocrinology and Nutrition, Girona Biomedical Research Institute (IDIBGI), University Hospital of Girona Dr Josep Trueta, Girona, Spain
- Department of Medicine, University of Girona, Girona, Spain
- CIBERobn Pathophysiology of Obesity and Nutrition, Institut of Salud Carlos III, Madrid, Spain
| | - G Bidault
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - M C Vázquez-Borrego
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
| | - A R Dias
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - B Pucker
- Genetics and Genomics of Plants, Centre for Biotechnology (CeBiTec) & Faculty of Biology, Bielefeld University, Bielefeld, Germany
- Evolution and Diversity, Department of Plant Sciences, University of Cambridge, Cambridge, UK
| | - M Dale
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - M Campbell
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, P. R. China
| | - S Carobbio
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Centro de Investigacion Principe Felipe, Valencia, Spain
| | - Y H Lin
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - M Vacca
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
- Insterdisciplinary Department of Medicine, Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - J Aron-Wisnewsky
- Sorbonne University, INSERM, NutriOmique Research Unit, Paris, France
- Assistance-Publique Hôpitaux de Paris, Nutrition department, Pitié-Salpêtrière hospital, Paris, France
| | - S Mora
- Dept Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona (IBUB), Barcelona, Spain
| | - M M Masiero
- The Beijer Laboratory and Department of Immunology, Genetics and Pathology, Uppsala University and SciLifeLab, Uppsala, Sweden
| | - A Emmanouilidou
- The Beijer Laboratory and Department of Immunology, Genetics and Pathology, Uppsala University and SciLifeLab, Uppsala, Sweden
| | - S Mukhopadhyay
- MRC Centre for Transplantation Peter Gorer Department of Immunobiology School of Immunology & Microbial Sciences King's College, London, UK
| | - G Dougan
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
- Division of Infectious Diseases, Department of Medicine, University of Cambridge, Cambridge, UK
| | - M den Hoed
- The Beijer Laboratory and Department of Immunology, Genetics and Pathology, Uppsala University and SciLifeLab, Uppsala, Sweden
| | - R J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - J M Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Girona Biomedical Research Institute (IDIBGI), University Hospital of Girona Dr Josep Trueta, Girona, Spain
- Department of Medicine, University of Girona, Girona, Spain
- CIBERobn Pathophysiology of Obesity and Nutrition, Institut of Salud Carlos III, Madrid, Spain
| | - D Chiarugi
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK
| | - K Clément
- Sorbonne University, INSERM, NutriOmique Research Unit, Paris, France
- Assistance-Publique Hôpitaux de Paris, Nutrition department, Pitié-Salpêtrière hospital, Paris, France
| | - A Vidal-Puig
- Wellcome-MRC Institute of Metabolic Science and MRC Metabolic Diseases Unit, University of Cambridge, Cambridge, UK.
- Cambridge University Nanjing Centre of Technology and Innovation, Nanjing, P. R. China.
- Centro de Investigacion Principe Felipe, Valencia, Spain.
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Barbois S, Stürm N, Aron-Wisnewsky J, Clément K, Bedossa P, Genser L, Hilleret MN, Costentin C, Reche F, Arvieux C, Borel AL. Decision Tree for the Performance of Intraoperative Liver Biopsy During Bariatric Surgery. Obes Surg 2021; 31:2641-2648. [PMID: 33665755 DOI: 10.1007/s11695-021-05309-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Bariatric surgery provides a useful opportunity to perform intraoperative liver biopsy to screen for non-alcoholic steatohepatitis (NASH). There is currently no consensus on whether intraoperative liver biopsy should be systematically performed. The aim of this study was to develop and validate a decision tree to guide that choice. APPROACH AND RESULTS This prospective study included 102 consecutive patients from the severe obesity outcome network (SOON) cohort in whom liver biopsy was systematically performed during bariatric surgery. A classification and regression tree (CART) was created to identify the nodes that best classified patients with and without NASH. External validation was performed. Seventy-one biopsies were of sufficient quality for analysis (median body mass index 43.3 [40.7; 48.0] kg/m2). NASH was diagnosed in 32.4% of cases. None of the patients with no steatosis on ultrasound had NASH. The only CART node that differentiated between a "high-risk" and a "low-risk" of NASH was alanine aminotransferase (ALT). ALT>53IU/L predicted NASH with a positive predictive value (PPV) of 68% and a negative predictive value (NPP) of 89%, a sensitivity of 77%, and a specificity of 84%. In the external cohort (n=258), PPV was 68%, NPV was 62%, sensitivity was 27%, and specificity was 90%. CONCLUSIONS The present work supports intraoperative liver biopsy to screen for NASH in patients with ALT>53IU/L; however, patients with no steatosis on ultrasound should not undergo biopsy. The CART failed to identify an algorithm with a good sensitivity to screen for NASH in patients with ultrasonography-proven steatosis and ALT≤53IU/L.
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Affiliation(s)
- Sandrine Barbois
- Department of Digestive Surgery, University Hospital Grenoble Alpes, 38043, Grenoble, France. .,Hypoxia Physiopathology (HP2) Laboratory, INSERM U1042, Grenoble Alpes University, 38043, Grenoble, France.
| | - N Stürm
- Department of Anatomopathology, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - J Aron-Wisnewsky
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - K Clément
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - P Bedossa
- Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Laurent Genser
- INSERM, NutriOmics Research Unit, Sorbonne Université, Paris, France.,Assistance Publique Hôpitaux de Paris, Digestive Surgery Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - M N Hilleret
- Department of Hepatology, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - C Costentin
- Department of Hepatology, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - F Reche
- Department of Digestive Surgery, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - C Arvieux
- Department of Digestive Surgery, University Hospital Grenoble Alpes, 38043, Grenoble, France
| | - A L Borel
- Hypoxia Physiopathology (HP2) Laboratory, INSERM U1042, Grenoble Alpes University, 38043, Grenoble, France.,Department of Nutrition, University Hospital Grenoble Alpes, 38043, Grenoble, France
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Rotge JY, Poitou C, Fossati P, Aron-Wisnewsky J, Oppert JM. Decision-making in obesity without eating disorders: a systematic review and meta-analysis of Iowa gambling task performances. Obes Rev 2017; 18:936-942. [PMID: 28429468 DOI: 10.1111/obr.12549] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND There is evidence that obesity is associated with impairments in executive functions, such as deficits in decision-making, planning or problem solving, which might interfere with weight loss in obese individuals. We performed a systematic review and meta-analysis of decision-making abilities, as measured with the Iowa gambling task (IGT), in obesity without eating disorders. METHODS A systematic search was conducted to identify studies comparing IGT performances between groups of obese patients without eating disorders and groups of healthy control groups. The standardized mean differences were calculated for the total IGT scores and for the course of IGT scores. Meta-regression analyses were performed to explore the influence of clinical variables on standardized mean differences. RESULTS Total IGT scores were significantly lower in obese patients compared with normal-weight healthy controls. IGT performances did not differ between groups for the first trials of the task. Significant effect sizes for the last trials of the task were subjected to a high degree of heterogeneity. CONCLUSION Risky decision-making is impaired in obesity. The clinical importance of non-food-related decision-making impairments remains to be assessed especially in terms of consequences in daily life or the achievement of weight loss. This meta-analysis has been registered in the Prospero database (CRD42016037533).
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Affiliation(s)
- J-Y Rotge
- Service de Psychiatrie d'Adultes, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013, Paris, France
| | - C Poitou
- Service de Nutrition, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,Sorbonne Universités, UPMC University Paris 06, INSERM, UMR_S 1166, Nutriomics Team, Paris, France
| | - P Fossati
- Service de Psychiatrie d'Adultes, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013, Paris, France
| | - J Aron-Wisnewsky
- Service de Nutrition, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,Sorbonne Universités, UPMC University Paris 06, INSERM, UMR_S 1166, Nutriomics Team, Paris, France
| | - J-M Oppert
- Service de Nutrition, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Universités, UPMC Univ Paris 06, Paris, France
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Phan F, Vatier C, Vauloup-Soupault C, Poitou C, Bouillot JL, Oppert JM, Aron-Wisnewsky J. Diabetes remission after bariatric surgery in obese patients with haemochromatosis. Diabetes Metab 2017; 44:185-187. [PMID: 28314670 DOI: 10.1016/j.diabet.2017.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/07/2017] [Indexed: 11/16/2022]
Affiliation(s)
- F Phan
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, France; Nutrition Department, Pitié-Salpêtrière Hospital, Nutrition Department, 75013 Paris, France
| | - C Vatier
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, France; INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France Sorbonne Universités, 75005 Paris, France; Endocrinology Department Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, 75013 Paris, France
| | - C Vauloup-Soupault
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, France; Nutrition Department, Pitié-Salpêtrière Hospital, Nutrition Department, 75013 Paris, France
| | - C Poitou
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, France; Nutrition Department, Pitié-Salpêtrière Hospital, Nutrition Department, 75013 Paris, France; Sorbonne Universités, UPMC Université Paris 06 and INSERM, UMR_S 1166, Team 6 Nutriomics, 75013 Paris, France
| | - J-L Bouillot
- Visceral Surgery Department, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, 92100 Boulogne-Billancourt, France
| | - J-M Oppert
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, France; Nutrition Department, Pitié-Salpêtrière Hospital, Nutrition Department, 75013 Paris, France; Paris 13 University, Sorbonne Paris Cité-Equipe de Recherche en Epidémiologie Nutritionnelle, U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et Biostatistiques, CRNH IdF, Bobigny, France
| | - J Aron-Wisnewsky
- Institute of Cardiometabolism and Nutrition, ICAN, Assistance Publique Hôpitaux de Paris, France; Nutrition Department, Pitié-Salpêtrière Hospital, Nutrition Department, 75013 Paris, France; Sorbonne Universités, UPMC Université Paris 06 and INSERM, UMR_S 1166, Team 6 Nutriomics, 75013 Paris, France.
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6
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Kayser BD, Lhomme M, Dao MC, Ichou F, Bouillot JL, Prifti E, Kontush A, Chevallier JM, Aron-Wisnewsky J, Dugail I, Clément K. Serum lipidomics reveals early differential effects of gastric bypass compared with banding on phospholipids and sphingolipids independent of differences in weight loss. Int J Obes (Lond) 2017; 41:917-925. [PMID: 28280270 DOI: 10.1038/ijo.2017.63] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/21/2017] [Accepted: 02/26/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES Circulating phospholipids and sphingolipids are implicated in obesity-related comorbidities such as insulin resistance and cardiovascular disease. How bariatric surgery affects these important lipid markers is poorly understood. We sought to determine whether Roux-en-Y gastric bypass (RYGB), which is associated with greater metabolic improvement, differentially affects the phosphosphingolipidome compared with adjustable gastric banding (AGB). SUBJECTS/METHODS Fasting sera were available from 59 obese women (body mass index range 37-51 kg m-2; n=37 RYGB and 22 AGB) before surgery, then at 1 (21 RYGB, 12 AGB) and 3 months follow-up (19 RYGB, 12 AGB). HPLC-MS/MS was used to quantify 131 lipids from nine structural classes. DXA measurements and laboratory parameters were also obtained. The associations between lipids and clinical measurements were studied with P-values adjusted for the false discovery rate (FDR). RESULTS Both surgical procedures rapidly induced weight loss and improved clinical profiles, with RYGB producing better improvements in fat mass, and serum total cholesterol, low-density lipoprotein-cholesterol (LDL-C) and orosomucoid (FDR <10%). Ninety-three (of 131) lipids were altered by surgery-the majority decreasing-with 29 lipids differentially affected by RYGB during the study period. The differential effect of the surgeries remained statistically significant for 20 of these lipids after adjusting for differences in weight loss between surgery types. The RYGB signature consisted of phosphatidylcholine species not exceeding 36 carbons, and ceramides and sphingomyelins containing C22 to C25 fatty acids. RYGB also led to a sustained increase in unsaturated ceramide and sphingomyelin species. The RYGB-specific lipid changes were associated with decreases in body weight, total and LDL-C, orosomucoid and increased HOMA-S (FDR <10%). CONCLUSIONS Concomitant with greater metabolic improvement, RYGB induced early and sustained changes in phosphatidylcholines, sphingomyelins and ceramides that were independent of greater weight loss. These data suggest that RYGB may specifically alter sphingolipid metabolism, which, in part, could explain the better metabolic outcomes of this surgical procedure.
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Affiliation(s)
- B D Kayser
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics Team, INSERM, UMR S U1166, Paris, France.,Nutriomics Team, Sorbonne Universités, UPMC University Paris 06, UMR_S 1166, Paris, France
| | - M Lhomme
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - M C Dao
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics Team, INSERM, UMR S U1166, Paris, France.,Nutriomics Team, Sorbonne Universités, UPMC University Paris 06, UMR_S 1166, Paris, France
| | - F Ichou
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - J-L Bouillot
- Visceral Surgery Department, Assistance Publique-Hôpitaux de Paris, Ambroise Paré, Paris, France
| | - E Prifti
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - A Kontush
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.,Dyslipidemia, Inflammation, and Atherosclerosis Team, INSERM, UMR_S U1166, Paris, France.,Dyslipidemia, Inflammation, and Atherosclerosis Team, Sorbonne Universités, UPMC Université Paris 06, UMR_S 1166, Institute of Cardiometabolism and Nutrition, Paris, France
| | - J-M Chevallier
- Visceral Surgery Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - J Aron-Wisnewsky
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics Team, INSERM, UMR S U1166, Paris, France.,Nutriomics Team, Sorbonne Universités, UPMC University Paris 06, UMR_S 1166, Paris, France
| | - I Dugail
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics Team, INSERM, UMR S U1166, Paris, France.,Nutriomics Team, Sorbonne Universités, UPMC University Paris 06, UMR_S 1166, Paris, France
| | - K Clément
- Nutriomics Team, Institute of Cardiometabolism and Nutrition, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.,Nutriomics Team, INSERM, UMR S U1166, Paris, France.,Nutriomics Team, Sorbonne Universités, UPMC University Paris 06, UMR_S 1166, Paris, France
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7
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Verger E, Nielsen T, Chakaroun R, Aron-Wisnewsky J, Delaere F, Gausserès N, Clément K, Holmes B. Évaluation de la validité relative du questionnaire de fréquence alimentaire développé pour les sujets français de l’étude MetaCardis. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Viglino D, Jullian-Desayes I, Minoves M, Aron-Wisnewsky J, Leroy V, Zarski J, Tamisier R, Joyeux-Faure M, Pepin J. La stéatose hépatique non alcoolique (NAFLD) dans la bronchopneumopathie chronique obstructive (BPCO). Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Paepegaey AC, Dubern B, Karsenty A, Chantereau H, Aron-Wisnewsky J, Oderda L, Hadoux M, Robert-Gary A, Bouillot JL, Oppert JM, Tounian P, Poitou C. [Bariatric surgery in obese adolescents: When and how should the transition from pediatric to adult medical management be made?]. Arch Pediatr 2016; 22:1233-9. [PMID: 26527542 DOI: 10.1016/j.arcped.2015.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 08/03/2015] [Accepted: 09/13/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In young obese patients, the transition from adolescence to adulthood, i.e., the transition from the pediatric to the adult medical team, is a new issue. In particular, it is important to define when and how this transition should be made in the setting of bariatric surgery. MATERIALS AND METHODS Fourteen young obese patients (under the age of 20), who underwent bariatric surgery, were included in the study (nine cases of Roux-en-Y gastric by-pass, three sleeve gastrectomy, one gastric banding). After surgery, the patients were followed in both the pediatric and adult departments (protocol 1) or only in the pediatric department during the 1st year and then in the adult department afterwards (protocol 2). Anthropometric and metabolic data, before and after surgery, and compliance monitoring were analyzed using a retrospective design. Twelve patients completed a questionnaire assessing how they experienced the transition. RESULTS Before surgery, mean age±SD was 16.3±1.8 years old and mean body mass index (BMI) 55.0±8.6kg/m(2). At 1 year after surgery, mean weight loss was -32.1±8.2% of initial body weight. Adherence to vitamin supplementation was judged to be adequate (vitamins were not taken less than once a week) for only 57.5% patients. Mean follow-up was 34.8±25.1 months [95% CI, 9.5-78.4]. None of the patients was lost to follow-up. Compliance was significantly better for patients following protocol 2. Adolescents reported being satisfied with meetings and newsletters about surgery, specific to this age group (91.7%). They also reported that information on the adult department was sufficient and 91.7% of them expressed satisfaction on the first outpatient visit in the adult department. However, all patients spontaneously reported having difficulties identifying members of the different teams: nutritionist pediatrician, nutritionist, and adult surgeon. DISCUSSION These preliminary data suggest that, in obese adolescents, it is important to differentiate the transition period and the time and preparation for bariatric surgery. A prospective follow-up with a larger number of subjects and recommendations are needed to better define and improve the specific clinical management of obese adolescents transitioning to adulthood.
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Affiliation(s)
- A-C Paepegaey
- Institut de cardiométabolisme et de nutrition (ICAN), service de nutrition, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - B Dubern
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, Assistance publique-Hôpitaux de Paris, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France
| | - A Karsenty
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, Assistance publique-Hôpitaux de Paris, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France
| | - H Chantereau
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
| | - J Aron-Wisnewsky
- Institut de cardiométabolisme et de nutrition (ICAN), service de nutrition, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France
| | - L Oderda
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, Assistance publique-Hôpitaux de Paris, 75013 Paris, France
| | - M Hadoux
- Institut de cardiométabolisme et de nutrition (ICAN), service de nutrition, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Robert-Gary
- Institut de cardiométabolisme et de nutrition (ICAN), service de nutrition, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - J-L Bouillot
- Service de chirurgie digestive et métabolique, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, 92104 Boulogne, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France
| | - J-M Oppert
- Institut de cardiométabolisme et de nutrition (ICAN), service de nutrition, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France
| | - P Tounian
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, Assistance publique-Hôpitaux de Paris, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France
| | - C Poitou
- Institut de cardiométabolisme et de nutrition (ICAN), service de nutrition, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie, Paris 6, 75005 Paris, France.
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Dubern B, Aron-Wisnewsky J, Karsenty A, Chantereau H, Oderda L, Clement K, Oppert J, Basdevant A, Bouillot J, Tounian P. CO-85 – Chirurgie bariatrique et obésité massive de l'adolescent. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30185-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Minville C, Hilleret MN, Tamisier R, Aron-Wisnewsky J, Clement K, Trocme C, Borel JC, Levy P, Zarski JP, Pepin JL. Hypoxie nocturne, stéatohépatite non alcoolique et dysfonction endothéliale au cours du syndrome d’apnées du sommeil (SAOS). Neurophysiol Clin 2013. [DOI: 10.1016/j.neucli.2013.01.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Aron-Wisnewsky J, Gaborit B, Dutour A, Clement K. Gut microbiota and non-alcoholic fatty liver disease: new insights. Clin Microbiol Infect 2013; 19:338-48. [DOI: 10.1111/1469-0691.12140] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 12/21/2012] [Indexed: 12/20/2022]
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Aron-Wisnewsky J, Minville C, Tordjman J, Levy P, Bouillot JL, Basdevant A, Bedossa P, Clement K, Pepin JL. La sévérité de l’hypoxie intermittente est un des déterminants majeurs de survenue de la stéatohépatite non alcoolique. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Aron-Wisnewsky J, Moutel S, Tordjman J, Dubern B, Cotillard A, Bouillot JL, Tounian P, Basdevant A, Clément K. P085 Altération des différents dépôts de tissu adipeux et du foie chez l’adolescent obèse avant une chirurgie bariatrique. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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