Background. Vertical sleeve gastrectomy (VSG) is a surgical weight loss procedure that resects 80% of the stomach, creating a tube linking the esophagus to the duodenum. Because of the efficacy and relative simplicity of VSG, it is preferred in the U.S with VSG currently at >61% of bariatric surgeries performed. Surprisingly, there has never been a complete molecular characterization of the human stomach fundus and corpus. Here we compare and contrast the molecular make-up of these regions. Methods. We performed a prospective study to obtain gastric tissue samples from patients undergoing VSG. Paired fundus and corpus samples were obtained Whole genome transcriptome analysis was performed by RNA sequencing, with key findings validated by qPCR. Results. Participants were primarily female (95.8%) and white (79.15%). Mean BMI, body weight, and age were 46.1 kg/m², 121.6 kg, and 43.29 years, respectively. Overall, 432 gene transcripts were significantly different between the fundus and corpus (p<0.05). A significant correlation was found between the RNAseq data set and qPCR validation, demonstrating robust gene expression differences. Significant genes included: progastricsin, acid chitinase, gastokine 1 and 2 in both fundus and corpus. Of the very highly expressed genes in both regions, 87% were present in both the stomach's fundus and corpus, indicating substantial overlap. Conclusions. Despite significant overlap in the greater curvature gene signature, regional differences exist. Given that the mechanism of VSG is partly unresolved, the potential that the resected tissue may express genes that influence long-term body weight regulation is unknown and could influence VSG outcomes.

中文翻译：

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人类垂直袖状胃切除术中切除的胃的全基因组转录组分析：减少的不仅仅是卡路里

背景。垂直袖状胃切除术 (VSG) 是一种外科减肥手术，可切除 80% 的胃，形成一条连接食道和十二指肠的管。由于 VSG 的疗效和相对简单性，它在美国是首选，目前 VSG 占减肥手术的 61% 以上。令人惊讶的是，人类胃底和胃体从未有过完整的分子特征。在这里，我们比较和对比这些区域的分子构成。方法。我们进行了一项前瞻性研究，以获取接受 VSG 的患者的胃组织样本。获得配对的眼底和体样本 通过 RNA 测序进行全基因组转录组分析，并通过 qPCR 验证关键发现。结果。参与者主要是女性（95.8%）和白人（79.15%）。平均体重指数、体重、²，分别为 121.6 公斤和 43.29 年。总体而言，432 个基因转录本在眼底和语体之间存在显着差异（p<0.05）。在 RNAseq 数据集和 qPCR 验证之间发现了显着的相关性，证明了强大的基因表达差异。重要基因包括：胃底和体中的前胃泌素、酸性几丁质酶、胃因子 1 和 2。在这两个区域的高表达基因中，87% 的基因同时存在于胃底和胃体中，表明存在大量重叠。结论。尽管大曲率基因特征存在显着重叠，但存在区域差异。鉴于 VSG 的机制部分未解决，切除组织可能表达影响长期体重调节的基因的潜力是未知的，并且可能影响 VSG 结果。