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March 07-08, 2019 | London, UK
Journal of Diabetology | Volume 3
Annual Summit on
Diabetes, Obesity & Heart
Diabetes, Endocrinology and Metabolic Syndrome
International Conference on
Joint Event
&
Impact of Roux-en-Y gastric bypass on metabolomic profile of obese women with type 2 diabetes
Natasha Machado
University of Sao Paulo, Brazil
T
ype 2 diabetes (T2D) remission rates reach up to 60% after
Roux-en-Y gastric bypass (RYGB) in obese patients, but the
precise mechanisms are not fully understood. We developed
a prospective clinical study to investigate the molecular basis
of these metabolic alterations through metabolomics. Plasma
and urine samples were collected from 23 obese women with
T2D before and after 3months of RYGB. Subjects were analysed
together and divided according T2D remission. Metabolomic
profile exhibited a discriminatory pattern of alterations,
suggesting important differences between patients with and
without T2D remission. The main metabolites involved in
these alterations includes bile acids, uremic toxins produced by
microbiota, dicarboxylic acids, and different lipid classes. The
contrast of the metabolite alterations allowed us to suggest
several hypotheses. T2D remission could be associated with
metabolic flexibility improvement, stimulated by increased
oxidation and nuclear receptors activation, modifying lipid
and glucose metabolism. In contrast, non-remission of T2D
in obese patients after RYGB could be related to a subclinical
kidney dysfunction. This was hypothesized considering that
metabolic alterations observed on T2D remission rely on kidney
function and its local enzymes and metabolite alterations of
patients who do not present T2D remission could be associated
to kidney disturbances. Thus, we suggest that RYGB deeply
changes metabolomic profile and develop a functional role,
including – but not limited to – regulation in the substrate
flux and utilization, microbiota composition or activity and
activation of nuclear receptors. These metabolic alterations
seem to act together to forma circuit of alterations that activate
triggers that lead to T2D improvement, which deserves future
investigations.
e:
natashamachado@gmail.com