Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
Plasma citric and fatty acid alteration linked to optimal weight loss after sleeve gastrectomy in people with morbid obesity.
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Park Ji-Hyeon, Ji Moongi, Paik Man-Jeong, Kim Seong Min, Lee Dae Ho
Аннотация
BACKGROUND: Targeted metabolomic profiling uncovers metabolic adaptations after bariatric surgery, but data in Asian populations remain limited.
OBJECTIVES: To investigate postoperative plasma metabolite changes and identify metabolic signatures associated with weight loss after sleeve gastrectomy (SG).
SETTING: A tertiary university hospital in Korea.
METHODS: We prospectively enrolled 49 Korean patients with severe obesity who underwent laparoscopic SG. Plasma samples were collected before and 6 months after SG. Targeted metabolomic profiling (liquid/gas chromatography-tandem mass spectrometry) quantified 101 metabolites-including amino acids, organic acids, fatty acids and nucleosides. Patients were categorized as optimal weight loss (OWL; total body weight loss [TBWL] ≥25%, n = 26) and suboptimal weight loss (SWL; TBWL< 25%, n = 23). Statistical comparisons and pathway enrichment analyses were performed.
RESULTS: Seventy-eight metabolites exhibited significant postoperative changes (false discovery rate< .05). Citric acid significantly increased after SG (Δ = 1.14 ng/μL, P < .001), with a greater increase in OWL than SWL (Δ = 1.98 vs. .19 ng/μL, P = .017), and was positively correlated with TBWL (r = .40, P = .005). Five fatty acids decreased significantly after SG. Two monounsaturated fatty acids-myristoleic and palmitoleic-decreased more in OWL, correlating negatively with TBWL (r = -.33 and -.28, respectively). In contrast, long/very-long-chain saturated fatty acids-eicosanoic, docosanoic, and tetracosanoic-decreased more in SWL, correlating positively with TBWL (r = .32, .44, and .39, respectively). Pathway enrichment highlighted tricarboxylic acid cycle and fatty acid degradation as key altered pathways.
CONCLUSION: SG induced distinct changes in plasma citric and fatty acid levels associated with weight-loss outcomes, suggesting mitochondrial adaptation and rebalanced fatty acid metabolic homeostasis during postoperative recovery.
OBJECTIVES: To investigate postoperative plasma metabolite changes and identify metabolic signatures associated with weight loss after sleeve gastrectomy (SG).
SETTING: A tertiary university hospital in Korea.
METHODS: We prospectively enrolled 49 Korean patients with severe obesity who underwent laparoscopic SG. Plasma samples were collected before and 6 months after SG. Targeted metabolomic profiling (liquid/gas chromatography-tandem mass spectrometry) quantified 101 metabolites-including amino acids, organic acids, fatty acids and nucleosides. Patients were categorized as optimal weight loss (OWL; total body weight loss [TBWL] ≥25%, n = 26) and suboptimal weight loss (SWL; TBWL< 25%, n = 23). Statistical comparisons and pathway enrichment analyses were performed.
RESULTS: Seventy-eight metabolites exhibited significant postoperative changes (false discovery rate< .05). Citric acid significantly increased after SG (Δ = 1.14 ng/μL, P < .001), with a greater increase in OWL than SWL (Δ = 1.98 vs. .19 ng/μL, P = .017), and was positively correlated with TBWL (r = .40, P = .005). Five fatty acids decreased significantly after SG. Two monounsaturated fatty acids-myristoleic and palmitoleic-decreased more in OWL, correlating negatively with TBWL (r = -.33 and -.28, respectively). In contrast, long/very-long-chain saturated fatty acids-eicosanoic, docosanoic, and tetracosanoic-decreased more in SWL, correlating positively with TBWL (r = .32, .44, and .39, respectively). Pathway enrichment highlighted tricarboxylic acid cycle and fatty acid degradation as key altered pathways.
CONCLUSION: SG induced distinct changes in plasma citric and fatty acid levels associated with weight-loss outcomes, suggesting mitochondrial adaptation and rebalanced fatty acid metabolic homeostasis during postoperative recovery.