The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

Glaysher, Michael A.; Ward, James; Aldhwayan, Madhawi; Ruban, Aruchuna; Prechtl, Christina Gabriele; Fisk, Helena L.; Chhina, Navpreet; Al‐Najim, Werd; Smith, Claire; Klimowska-Nassar, Natalia; Johnson, Nicholas; Falaschetti, Emanuela; Goldstone, Anthony P.; Miras, Alexander D.; Byrne, James P.; Calder, Philip C.; Teare, Julian

doi:10.1016/j.clnu.2020.10.026

Cited by 14 publications

(29 citation statements)

References 54 publications

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“…Several other studies that have examined plasma NEFA profiles in patients after various types of bariatric surgery have found such interventions to lead to significant reductions in total NEFA concentrations (and groups of fatty acids) in the months following surgery 28 – 33 , in a manner similar to that observed in this study. A meta-analysis published in 2016 found that serum NEFA levels were decreased at 6 and 12 months but did not differ from preoperative levels at 3 months post-surgery 34 .…”

Section: Resultssupporting

confidence: 81%

Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism

Hierons

Abbas

Sobczak

et al. 2022

Sci Rep

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Obesity is a complex disease that increases an individual’s risk of developing other diseases and health-related problems. A common feature is dyslipidemia characterized by increased levels of plasma lipids, which include non-esterified fatty acids (NEFAs). The role of NEFAs in obesity-related morbidity is interesting as NEFAs constitute a reservoir of metabolic energy, are principal components of cell membranes and are precursors for signalling molecules. Bariatric surgery promotes sustained weight loss in severely obese patients, reducing the incidence and severity of co-morbidities. In this study we measure changes in circulating NEFA species in plasma samples taken from 25 obese individuals before and 9 months after Roux-en-Y gastric bypass surgery. The mean weight of the cohort reduced by 29.2% from 149.0 ± 25.1 kg pre-surgery to 105.5 ± 19.8 kg post-surgery and the BMI by 28.2% from 51.8 ± 6.3 kg/m2 pre-surgery to 37.2 ± 5.4 kg/m2. Mean glycated haemoglobin (HbA1c) reduced from 6.5 ± 1.3 to 5.5 ± 0.5%, consistent with the intervention leading to improved glycaemic control, particularly in those who were dysglycemic prior to surgery. Total and LDL cholesterol concentrations were markedly reduced following surgery. Concentrations of seven NEFAs were found to decrease 9 months after surgery compared to pre-surgery levels: myristate, palmitoleate, palmitate, linoleate, oleate, stearate and arachidonate. Bariatric surgery led to increased lipogenesis and elongase activity and decreased stearoyl-CoA desaturase 1 activity. This study therefore highlights metabolic changes that take place following gastric bypass surgery in severely obese patients.

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Section: Resultssupporting

confidence: 81%

Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism

Hierons

Abbas

Sobczak

et al. 2022

Sci Rep

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“…Similarly, for the other cardiometabolic risk factors such as blood pressure, EFAs, total cholesterol, and LDL cholesterol, Laubner et al ( 40 ) and Glaysher et al ( 38 ) both showed significant decreases in the DJBL group vs. the SMT group. However, Caiazzo et al ( 39 ) found that there was no significant difference in BMI loss, HOMA2, blood pressure, HDL cholesterol and triglycerides after removal of DJBL.…”

Section: Resultsmentioning

confidence: 88%

“…Four randomized controlled trials and one case control study investigated the effects of DJBL on weight loss ( Table 5 ). Large-sample randomized controlled trials (of 170 participants each) conducted by Ruban et al ( 37 ) and Glaysher et al ( 38 ) both showed significantly greater TBWL in the DJBL group vs. SMT group, Three studies comprising 510 participants ( 21 , 38 , 40 ) studied change in BMI between the DJBL and SMT group at 6 months ( Figure 2D ). Our analysis showed no significant reduction in BMI between the DJBL and SMT group (WMD −2.73 (−5.52, 0.07) kg/m 2 )).…”

Section: Resultsmentioning

confidence: 96%

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Endoscopic Bariatric and Metabolic Therapies and Their Effects on Metabolic Syndrome and Non-alcoholic Fatty Liver Disease - A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundEndoscopic bariatric and metabolic therapies (EBMTs) are procedures that utilize instruments that require flexible endoscopy or placement of devices for inducing weight loss. We perform a systematic review and meta-analysis to evaluate four modalities – intragastric balloon (IGB), endoscopic sleeve gastroplasty (ESG), duodeno-jejunal bypass liner (DJBL), and duodenal mucosa resurfacing (DMR), for their efficacy and safety on weight loss, non-alcoholic fatty liver disease, and metabolic syndrome.MethodsDatabases MEDLINE via PubMed, and EMBASE are searched and relevant publications up to January 26, 2022 are assessed. Studies are included if they involved human participants diagnosed with obesity and obesity-related comorbid conditions who are treated with any of the 4 EBMTs. IGB and DJBL were chosen as the interventions for the meta-analysis with weight loss (percentage total body weight loss or body mass index) and glycemic control (fasting plasma glucose or HbA1c) as the two main outcomes analyzed.ResultsSix hundred and forty-eight records are reviewed, of which 15 studies are found to be duplicates. Of the 633 records screened, 442 studies are excluded. One hundred and ninety-one articles are assessed for eligibility, for which 171 are excluded. A total of 21 publications are included. Twelve studies are on IGB, two studies on ESG, five studies on DJBL, and two studies on DMR. In these studies with appropriate control, IGB, ESG, and DJBL showed promising benefits on weight loss reduction compared to standard medical therapy (SMT), while DMR appeared to have the least weight reduction benefit. However, the impact on glycemic control featured more prominently in DMR as compared to the rest of the modalities. Different EBMTs have different adverse effect profiles, although device-related adverse events are featured more prominently in DJBL. In the IGB group, there was a significant reduction in 6-month %TBWL [weighted mean difference (WMD) 5.45 (3.88, 7.05)] and FPG WMD −4.89 mg/dL (−7.74, −2.04) compared to the SMT group. There was no significant reduction in BMI between the DJBL and SMT group WMD −2.73 (−5.52, 0.07) kg/m2.ConclusionEBMTs have demonstrated a significant impact on weight loss and metabolic comorbidities, and reasonable safety profiles in the studies reviewed. Some data is available to demonstrate reduction of hepatic steatosis, but there is no high-quality data supporting benefits on hepatic lobular inflammation or fibrosis.

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“…Thus, DPA affected colon motility and induced constipation only when applied through the colon in vitro but not through diet. This may be due to the fact that, similar to other PUFAs, dietary DPA is absorbed thoroughly in the small intestine ( 26 ). It is plausible that the fecal DPA we detected in the IFC patients was primarily produced by PIB in the colon rather than by food intake.…”

Section: Discussionmentioning

confidence: 99%

A Shigella species variant is causally linked to intractable functional constipation

Chen¹,

Qiu²,

Wang³

et al. 2022

Journal of Clinical Investigation

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Intractable functional constipation (IFC) is the most severe form of constipation, but its etiology has long been unknown. We hypothesized that IFC is caused by refractory infection by a pathogenic bacterium. Here, we isolated from patients with IFC a Shigella species — peristaltic contraction–inhibiting bacterium (PIB) — that significantly inhibited peristaltic contraction of the colon by production of docosapentenoic acid (DPA). PIB colonized mice for at least 6 months. Oral administration of PIB was sufficient to induce constipation, which was reversed by PIB-specific phages. A mutated PIB with reduced DPA was incapable of inhibiting colonic function and inducing constipation, suggesting that DPA produced by PIB was the key mediator of the genesis of constipation. PIBs were detected in stools of 56% (38 of 68) of the IFC patients, but not in those of non-IFC or healthy individuals (0 of 180). DPA levels in stools were elevated in 44.12% (30 of 68) of the IFC patients but none of the healthy volunteers (0 of 97). Our results suggest that Shigella sp. PIB may be the critical causative pathogen for IFC, and detection of fecal PIB plus DPA may be a reliable method for IFC diagnosis and classification.

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The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

Cited by 14 publications

References 54 publications

Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism

Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism

Endoscopic Bariatric and Metabolic Therapies and Their Effects on Metabolic Syndrome and Non-alcoholic Fatty Liver Disease - A Systematic Review and Meta-Analysis

A Shigella species variant is causally linked to intractable functional constipation

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