Changes in blood microRNA expression and early metabolic responsiveness 21 days following bariatric surgery

Stephen Atkin, Vimal Ramachandran, Noha Yousri, Manasi Benurwar, Steven C. Simper, Rodrick McKinlay, Ted D. Adams, Hani Najafi, Steven Hunt

Research output: Contribution to journalArticle

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Abstract

Background: Early metabolic responses following bariatric surgery appear greater than expected given the initial weight loss and coincide with improvement in diabetes. We hypothesized that small non-coding microRNA changes might contribute to regulating mechanisms for metabolic changes and weight loss in patients with severe obesity and diabetes. Methods: Twenty-nine type 2 patients with severe obesity (mean BMI 46.2 kg/m 2 ) and diabetes underwent Roux-en-Y gastric bypass (RYGB) surgery. Clinical measurements and fasting blood samples were taken preoperatively and at day 21 postoperatively. Normalization of fasting glucose and HbA1c following bariatric surgery (short-term diabetes remission) was defined as withdrawal of anti-diabetic medication and fasting glucose < 100 mg/dL (5.6 mmol/L) or HbA1c < 6.0%. MicroRNA expression was determined by quantitative polymerase chain reaction and tested for significant changes after surgery. Results: BMI decreased by 3.8 kg/m 2 21 days postoperatively. Eighteen of 29 RYGB (62%) had short-term diabetes remission. Changes from pre- to post-surgery in 32 of 175 microRNAs were nominally significant (p < 0.05). Following multiple comparison adjustment, changes in seven microRNAs remained significant: miR-7-5p, let-7f-5p, miR-15b-5p, let-7i-5p, miR-320c, miR-205-5p, and miR-335-5p. Four pathways were over-represented by these seven microRNAs, including diabetes and insulin resistance pathways. Conclusion: Seven microRNAs showed significant changes 21 days after bariatric surgery. Functional pathways of the altered microRNAs were associated with diabetes-, pituitary-, and liver-related disease, with expression in natural killer cells, and pivotal intestinal pathology suggesting possible mechanistic roles in early diabetes responses following bariatric surgery. Perspective Section • Metabolic changes following bariatric surgery can be rapid and precede substantial weight loss, the causes of which remains unclear. • Non-coding microRNAs were measured before and 21 days after bariatric surgery and showed changes associated with bariatric surgery. • The physiological pathways associated with these microRNAs may identify biomarkers of surgical response and an understanding of weight loss or long-term diabetes remission.

Original languageEnglish
JournalFrontiers in Endocrinology
Volume10
Issue numberJAN
DOIs
Publication statusPublished - 1 Jan 2019

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Bariatric Surgery
MicroRNAs
Weight Loss
Fasting
Gastric Bypass
Morbid Obesity
Social Adjustment
Glucose
Natural Killer Cells
Insulin Resistance
Liver Diseases
Biomarkers
Pathology
Polymerase Chain Reaction

Keywords

  • Bariatric surgery
  • Biomarkers
  • Diabetes
  • Gastric bypass
  • MicroRNA

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Changes in blood microRNA expression and early metabolic responsiveness 21 days following bariatric surgery. / Atkin, Stephen; Ramachandran, Vimal; Yousri, Noha; Benurwar, Manasi; Simper, Steven C.; McKinlay, Rodrick; Adams, Ted D.; Najafi, Hani; Hunt, Steven.

In: Frontiers in Endocrinology, Vol. 10, No. JAN, 01.01.2019.

Research output: Contribution to journalArticle

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AU - McKinlay, Rodrick

AU - Adams, Ted D.

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AU - Hunt, Steven

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N2 - Background: Early metabolic responses following bariatric surgery appear greater than expected given the initial weight loss and coincide with improvement in diabetes. We hypothesized that small non-coding microRNA changes might contribute to regulating mechanisms for metabolic changes and weight loss in patients with severe obesity and diabetes. Methods: Twenty-nine type 2 patients with severe obesity (mean BMI 46.2 kg/m 2 ) and diabetes underwent Roux-en-Y gastric bypass (RYGB) surgery. Clinical measurements and fasting blood samples were taken preoperatively and at day 21 postoperatively. Normalization of fasting glucose and HbA1c following bariatric surgery (short-term diabetes remission) was defined as withdrawal of anti-diabetic medication and fasting glucose < 100 mg/dL (5.6 mmol/L) or HbA1c < 6.0%. MicroRNA expression was determined by quantitative polymerase chain reaction and tested for significant changes after surgery. Results: BMI decreased by 3.8 kg/m 2 21 days postoperatively. Eighteen of 29 RYGB (62%) had short-term diabetes remission. Changes from pre- to post-surgery in 32 of 175 microRNAs were nominally significant (p < 0.05). Following multiple comparison adjustment, changes in seven microRNAs remained significant: miR-7-5p, let-7f-5p, miR-15b-5p, let-7i-5p, miR-320c, miR-205-5p, and miR-335-5p. Four pathways were over-represented by these seven microRNAs, including diabetes and insulin resistance pathways. Conclusion: Seven microRNAs showed significant changes 21 days after bariatric surgery. Functional pathways of the altered microRNAs were associated with diabetes-, pituitary-, and liver-related disease, with expression in natural killer cells, and pivotal intestinal pathology suggesting possible mechanistic roles in early diabetes responses following bariatric surgery. Perspective Section • Metabolic changes following bariatric surgery can be rapid and precede substantial weight loss, the causes of which remains unclear. • Non-coding microRNAs were measured before and 21 days after bariatric surgery and showed changes associated with bariatric surgery. • The physiological pathways associated with these microRNAs may identify biomarkers of surgical response and an understanding of weight loss or long-term diabetes remission.

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