Priscilla Sampaio, Dan Linetzky Waitzberg, Natasha Mendonça Machado, Raquel Susana Matos de Miranda Torrinhas, Danielle C Fonseca, Beatriz A M Ferreira, Mariane Marques, Samira Barcelos, Robson Kiyoshi Ishida, Ismael Francisco Mota Siqueira Guarda, Eduardo Guimarães Hourneaux de Moura, Paulo Sakai, Marco Aurélio Santo, Steven B Heymsfield, Maria Lúcia Corrêa-Giannella, Mariana Doce Passadore, Priscila Sala
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Intestinal biopsies were obtained through double-balloon endoscopy in 20 women with obesity (age 46.9±6.2 years; body mass index [BMI] 46.5±5.3 kg/m<sup>2</sup> [mean±SD]) before and three months after RYGB (BMI, 38.2±4.2 kg/m<sup>2</sup>). Intestinal mucosal gene microarray analyses were performed in samples using a Human GeneChip 1.0 ST array (Affymetrix). Vitamin A intake was assessed from 7-day food records and serum retinol levels were evaluated by electrochemiluminescence immunoassay. Our results showed the following genes with significant downregulation (p≤0.05): LIPF (-0.60), NPC1L1 (-0.71), BCO1 (-0.45), and RBP4 (-0.13) in the duodenum; CD36 (-0.33), and ISX (-0.43) in the jejunum and BCO1 (-0.29) in the ileum. No significant changes in vitamin A intake were found (784±694 retinol equivalents [RE] pre-operative vs. 809±753 RE post-operative [mean±SD]). Although patients were routinely supplemented with 3500 international units IU/day (equivalent to 1050 μg RE/day) of oral retinol palmitate, serum concentrations were lower in the post-operative when compared to pre-operative period (0.35±0.14 μg/L vs. 0.52±0.33 μg/L, respectively - P=0.07), both within the normal range. 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引用次数: 0
摘要
Roux-en-Y 胃旁路术(RYGB)是最常用的减肥手术技术之一。然而,RYGB 通常会导致营养缺乏等副作用。本研究旨在检测胃肠道(GI)中维生素 A 途径编码基因表达的变化,并评估 RYGB 术后维生素 A 缺乏的潜在机制。研究人员通过双球囊内镜获取了20名肥胖女性(年龄46.9±6.2岁;体重指数[BMI] 46.5±5.3 kg/m2 [平均±SD])在RYGB(体重指数38.2±4.2 kg/m2)之前和之后三个月的肠道活检组织。使用人类基因芯片 1.0 ST 阵列(Affymetrix)对样本进行肠粘膜基因芯片分析。维生素 A 摄入量通过 7 天的食物记录进行评估,血清视黄醇水平通过电化学发光免疫测定进行评估。我们的结果显示,下列基因有明显的下调(p≤0.05):十二指肠中的 LIPF(-0.60)、NPC1L1(-0.71)、BCO1(-0.45)和 RBP4(-0.13);空肠中的 CD36(-0.33)和 ISX(-0.43)以及回肠中的 BCO1(-0.29)。维生素 A 的摄入量未发现明显变化(术前为 784±694 视黄醇当量 [RE],术后为 809±753 RE [平均值±SD])。虽然患者常规补充口服棕榈酸视黄醇 3500 国际单位 IU/天(相当于 1050 μg RE/天),但术后血清浓度低于术前(分别为 0.35±0.14 μg/L vs. 0.52±0.33 μg/L - P=0.07),均在正常范围内。RYGB 术后,消化道基因表达的同步变化可能会影响肠细胞中类胡萝卜素的代谢、新生乳糜微粒的形成和视黄醇的转运,从而导致维生素 A 的可用性降低。
Gastrointestinal genetic reprogramming of vitamin A metabolic pathways in response of Roux-en-Y gastric bypass.
Roux-en-Y gastric bypass (RYGB) is one of the most performed bariatric surgical techniques. However, RYGB commonly results, as side effects, in nutritional deficiencies. This study aimed to examine changes in the expression of vitamin A pathway encoding genes in the gastrointestinal tract (GI) and to evaluate the potential mechanisms associated with hypovitaminosis A after RYGB. Intestinal biopsies were obtained through double-balloon endoscopy in 20 women with obesity (age 46.9±6.2 years; body mass index [BMI] 46.5±5.3 kg/m2 [mean±SD]) before and three months after RYGB (BMI, 38.2±4.2 kg/m2). Intestinal mucosal gene microarray analyses were performed in samples using a Human GeneChip 1.0 ST array (Affymetrix). Vitamin A intake was assessed from 7-day food records and serum retinol levels were evaluated by electrochemiluminescence immunoassay. Our results showed the following genes with significant downregulation (p≤0.05): LIPF (-0.60), NPC1L1 (-0.71), BCO1 (-0.45), and RBP4 (-0.13) in the duodenum; CD36 (-0.33), and ISX (-0.43) in the jejunum and BCO1 (-0.29) in the ileum. No significant changes in vitamin A intake were found (784±694 retinol equivalents [RE] pre-operative vs. 809±753 RE post-operative [mean±SD]). Although patients were routinely supplemented with 3500 international units IU/day (equivalent to 1050 μg RE/day) of oral retinol palmitate, serum concentrations were lower in the post-operative when compared to pre-operative period (0.35±0.14 μg/L vs. 0.52±0.33 μg/L, respectively - P=0.07), both within the normal range. After RYGB, the simultaneous change in expression of GI genes, may impair carotenoid metabolism in the enterocytes, formation of nascent chylomicrons and transport of retinol, resulting in lower availability of vitamin A.
期刊介绍:
Since 1930 this journal has provided an important international forum for scientific advances in the study of nutrition and vitamins. Widely read by academicians as well as scientists working in major governmental and corporate laboratories throughout the world, this publication presents work dealing with basic as well as applied topics in the field of micronutrients, macronutrients, and non-nutrients such as secondary plant compounds.
The editorial and advisory boards include many of the leading persons currently working in this area.
The journal is of particular interest to:
- Nutritionists
- Vitaminologists
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