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Abstract: TH-PO847

Measured GFR Adjusted Metabolic Changes Following Bariatric Surgery

Session Information

Category: Health Maintenance‚ Nutrition‚ and Metabolism

  • 1400 Health Maintenance‚ Nutrition‚ and Metabolism

Authors

  • Apple, Benjamin J., Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States
  • Chen, Jingsha, Johns Hopkins University Welch Center for Prevention Epidemiology and Clinical Research, Baltimore, Maryland, United States
  • Mirshahi, Tooraj, Geisinger Medical Center, Danville, Pennsylvania, United States
  • Levey, Andrew S., Tufts Medical Center, Boston, Massachusetts, United States
  • Inker, Lesley Ann, Tufts Medical Center, Boston, Massachusetts, United States
  • Grams, Morgan, New York University Grossman School of Medicine, New York, New York, United States
  • Coresh, Josef, Johns Hopkins University Welch Center for Prevention Epidemiology and Clinical Research, Baltimore, Maryland, United States
  • Chang, Alex R., Geisinger Medical Center, Danville, Pennsylvania, United States
Background

Bariatric surgery reduces glomerular hyperfiltration in the short term and is associated with a reduced risk of end-stage kidney disease during long-term follow-up. Assessing surgery-induced changes in serum metabolites may be useful to understand the salutary metabolic changes that occur after bariatric surgery.

Methods

In a prospective, single-center research cohort of 27 adults with severe obesity who underwent bariatric surgery, we measured serum metabolites using untargeted ultrahigh-performance liquid chromatography-tandem mass spectrometry and measured glomerular filtration rate (mGFR) by iohexol clearance approximately 1-3 months prior and 6 months after bariatric surgery. Generalized estimated equations (GEE) were used to examine changes in serum metabolites after surgery.

Results

Bariatric surgery was significantly associated with 223 serum metabolites after adjustment for age, sex, and log(mGFR) at a Bonferroni-corrected p-value <4.85E-05. Following bariatric surgery, the levels of many metabolites associated with insulin resistance and inflammation decreased, such as branch-chain amino acids (tigylyl carnitine, isovalerylcarnitine, alpha-hydroxyisovalerate), kynurenine pathway (kynurenine, xanthurenate, 8-methoxykyunurenate, quinolinate), sphingomyelin metabolites (behenoyl dihydrosphingomyelin, sphingomyelin, tricosanoyl sphingomyelin). Additionally, creatinine decreased following surgery independent of mGFR. Increases in metabolite levels occurred for insulin sensitivity-promoting primary bile acid metabolites (cholic acid glucuronide, cholate, glycol-beta-muricholate), antioxidant plasmalogen metabolites (1-2-oleoyl-GPC, 1-2-palmitoleoyl-GPC), and microbiome-derived acetylated peptide metabolites (phenylacetylglutamate, phenylacetylglutamine).

Conclusion

After adjustment for mGFR, we confirm several metabolic changes after bariatric surgery, which could have favorable renal benefits.

Volcano Plot

Funding

  • NIDDK Support