BACKGROUND While Roux-en-Y gastric bypass (RYGB) is one of the most effective and durable treatment options for obesity and its comorbidities, it is complicated by long-term weight regain in over 20% of patients. AIMS We sought to determine the metabolite signatures of serum samples of patients with weight regain (RYGB-WR) after RYGB and features distinguishing these patients from patients with sustained weight loss (RYGB-SWL). METHODS We prospectively analyzed serum samples from 21 RYGB-WR patients, 14 RYGB-SWL patients, and 11 unoperated controls. The main outcome measure was their serum metabolite profile. RESULTS Weight regain after RYGB was associated with a unique serum metabolomic fingerprint. Most of the statistically different metabolites were involved in amino acid metabolism, one-carbon metabolism, and related nucleotide metabolism. A principal component analysis identified groups of metabolites that correlate with weight regain. Specifically, weight regain was associated with lower serum levels of metabolites related to the serine, glycine and threonine pathway, phenylalanine metabolism, tricyclic acid cycle, alanine and glutamate metabolism, and higher levels of other amino acids. CONCLUSIONS Weight regain after RYGB is associated with unique serum metabolite signatures. Metabolite profiling may eventually help us to identify markers that could differentiate the patients who will regain weight versus those who will likely sustain weight loss.

中文翻译：

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胃旁路手术后体重恢复和体重持续减轻的患者的代谢组学特征差异：一项先导研究。

背景尽管Roux-en-Y胃搭桥术（RYGB）是肥胖及其合并症最有效，最持久的治疗选择之一，但由于超过20％的患者长期体重减轻，这一问题变得复杂了。目的我们试图确定RYGB后体重恢复患者（RYGB-WR）的血清样品的代谢物特征，并区分这些患者与持续减肥患者（RYGB-SWL）。方法我们前瞻性分析了21例RYGB-WR患者，14例RYGB-SWL患者和11例未经手术的对照组的血清样本。主要结果指标是其血清代谢产物谱。结果RYGB后的体重恢复与独特的血清代谢组学指纹相关。统计学上大多数不同的代谢物都参与氨基酸代谢，一碳代谢和相关的核苷酸代谢。主成分分析确定了与体重增加相关的代谢物组。具体而言，体重恢复与血清中与丝氨酸，甘氨酸和苏氨酸途径，苯丙氨酸代谢，三环酸循环，丙氨酸和谷氨酸代谢有关的代谢产物水平较低以及其他氨基酸水平较高有关。结论RYGB后体重的恢复与独特的血清代谢产物特征有关。代谢物谱分析最终可以帮助我们识别标志物，这些标志物可以区分体重减轻患者和体重减轻患者。苯丙氨酸代谢，三环酸循环，丙氨酸和谷氨酸代谢以及其他氨基酸含量较高。结论RYGB后体重的恢复与独特的血清代谢产物特征有关。代谢物谱分析最终可以帮助我们识别标志物，这些标志物可以区分体重减轻患者和体重减轻患者。苯丙氨酸代谢，三环酸循环，丙氨酸和谷氨酸代谢以及其他氨基酸含量更高。结论RYGB后体重的恢复与独特的血清代谢产物特征有关。代谢物谱分析最终可以帮助我们识别标志物，这些标志物可以区分体重减轻患者和体重减轻患者。