Regulation of metabolic pathways genes and the effects of very low-calorie diet on insulin resistance and fatty acid profiles in obese patients undergoing bariatric surgery.

IF 1.6 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes and Metabolic Disorders Pub Date : 2025-05-07 eCollection Date: 2025-06-01 DOI:10.1007/s40200-025-01625-5

Manoj Kumar, Vibhav Nigam, Sandeep Kumar, Anumesh K Pathak

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引用次数: 0

Abstract

Objectives: To evaluate the effects of a very-low-calorie diet (VLCD) on insulin resistance (IR), metabolic gene expression, and fatty acid profiles in obese patients (body mass index [BMI] ≥ 30 kg/m²) undergoing bariatric surgery compared to age- and sex-matched nonobese controls (BMI ≤ 25 kg/m²) undergoing elective abdominal surgery.

Methods: A total of 38 participants (21 obese and 17 nonobese controls) were recruited for this study. Obese patients underwent VLCD (800 kcal/day) for four weeks before surgery. Fasting blood samples and tissue biopsies were collected during surgery. Key parameters included IR (measured using HOMA-IR), metabolic gene expression (quantified via RT-PCR), and fatty acid composition (analyzed by gas chromatography). Data were compared between pre- and post-VLCD groups in the obese cohort.

Results: GLUT4 expression was reduced (1.57-fold, p = 0.025), whereas PDK4 (3.9-fold, p = 0.002), CPT1 (2.5-fold, p = 0.013), and AMPK (twofold, p = 0.004) expression were Correlation analysis revealed that GLUT4 was negatively correlated with BMI (r = -0.85), glucose (r = -0.94), and IR (r = -0.79), CPT1 was positively correlated with these parameters (BMI: r = 0.84, glucose: r = 0.92, IR: r = 0.82). VLCD significantly reduced monounsaturated fatty acids, including alpha-linolenic acid (p = 0.03) and erucic acid (p = 0.019). Postsurgical improvements included reductions in BMI (Δ = 6.21, p < 0.0001), glucose level (Δ = 6.94, p = 0.0007), and IR (Δ = 10.19, p = 0.0039).

Conclusion: VLCD modulated metabolic gene expression and fatty acid profiles, enhancing IR and metabolic health both pre- and post-surgery. This represents a critical strategy for optimizing the outcomes of obese patients undergoing bariatric surgery.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01625-5.

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代谢途径基因的调节和极低热量饮食对接受减肥手术的肥胖患者胰岛素抵抗和脂肪酸谱的影响

目的：评估极低热量饮食（VLCD）对接受减肥手术的肥胖患者（体重指数[BMI]≥30 kg/m2）的胰岛素抵抗（IR）、代谢基因表达和脂肪酸谱的影响，并与年龄和性别匹配的接受择期腹部手术的非肥胖对照组（BMI≤25 kg/m2）进行比较。方法：本研究共招募了38名参与者（21名肥胖和17名非肥胖对照）。肥胖患者术前4周接受VLCD（800千卡/天）。术中采集空腹血样和组织活检。关键参数包括IR（使用HOMA-IR测量），代谢基因表达（通过RT-PCR定量）和脂肪酸组成（通过气相色谱分析）。比较肥胖队列中vlcd前后两组的数据。结果：GLUT4表达减少（1.57倍，p = 0.025），而PDK4表达减少（3.9倍，p = 0.002）、CPT1表达减少（2.5倍，p = 0.013）、AMPK表达减少（2倍，p = 0.004）。相关分析显示，GLUT4与BMI （r = -0.85）、葡萄糖（r = -0.94）、IR （r = -0.79）呈负相关，CPT1与这些参数呈正相关（BMI: r = 0.84，葡萄糖：r = 0.92, IR: r = 0.82）。VLCD显著降低了单不饱和脂肪酸，包括α -亚麻酸（p = 0.03）和芥酸（p = 0.019）。术后改善包括BMI （Δ = 6.21, p p = 0.0007）和IR （Δ = 10.19, p = 0.0039）的降低。结论：VLCD调节了代谢基因表达和脂肪酸谱，改善了术前和术后IR和代谢健康。这是优化肥胖患者接受减肥手术结果的关键策略。补充资料：在线版本提供补充资料，网址为10.1007/s40200-025-01625-5。

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来源期刊

Journal of Diabetes and Metabolic Disorders Medicine-Internal Medicine

CiteScore

4.80

自引率

3.60%

发文量

210

期刊介绍： Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.