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1.
Clin Nutr ; 38(3): 1280-1288, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30459098

RESUMO

BACKGROUND & AIMS: Roux-en-Y gastric bypass (RYGB) limits food ingestion and may alter the intestinal expression of genes involved in the endogenous synthesis of polyunsaturated fatty acids (PUFAs). These changes may decrease the systemic availability of bioactive PUFAs after RYGB. To study the impact of RYGB on the dietary ingestion and plasma concentration of PUFAs and on the intestinal expression of genes involved in their endogenous biosynthesis in severely obese women with type 2 diabetes. METHODS: Before, and 3 and 12 months after RYGB, obese women (n = 20) self-reported a seven-day dietary record, answered a food frequency query and provided plasma samples for alpha-linolenic (ALA), eicosapentaenoic (EPA), docosahexaenoic (DHA) and arachidonic (ARA) acid assessment by gas chromatography. Intestinal biopsies (duodenum, jejunum and ileum) were collected through double-balloon endoscopy before and 3 months after RYGB for gene expression analysis by microarray (Human GeneChip 1.0 ST array) and RT-qPCR validation. RESULTS: Compared to the preoperative period, patients had decreased intakes of PUFAs, fish and soybean oil (p < 0.05) and lower plasma concentrations of ALA and EPA (p < 0.001) 3 and 12 months after RYGB. FADS1 gene expression was lower in duodenum (RT-qPCR fold change = -1.620, p < 0.05) and jejunum (RT-qPCR fold change = -1.549, p < 0.05) 3 months following RYGB, compared to before surgery. CONCLUSION: RYGB decreased PUFA ingestion, plasma ALA and EPA levels, and intestinal expression of FADS1 gene. The latter encodes a key enzyme involved in endogenous biosynthesis of PUFAs. These data suggest that supplementation of omega-3 PUFAs may be required for obese patients undergoing RYGB. Clinical Trial Registry number and website: www.clinicaltrials.gov - NCT01251016; Plataforma Brasil - 19339913.0.0000.0068.


Assuntos
Ácidos Graxos Dessaturases , Ácidos Graxos Ômega-3/sangue , Derivação Gástrica , Adolescente , Adulto , Dessaturase de Ácido Graxo Delta-5 , Registros de Dieta , Ácidos Graxos Dessaturases/análise , Ácidos Graxos Dessaturases/genética , Ácidos Graxos Dessaturases/metabolismo , Feminino , Humanos , Intestinos/química , Pessoa de Meia-Idade , Obesidade/metabolismo , Obesidade/cirurgia , Adulto Jovem
2.
J Int Med Res ; 44(6): 1359-1375, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27834300

RESUMO

Objective To describe the protocol of the SURgically induced Metabolic effects on the Human GastroIntestinal Tract (SURMetaGIT) study, a clinical pan-omics study exploring the gastrointestinal tract as a central organ driving remission of type 2 diabetes mellitus (T2DM) after Roux-en-Y gastric bypass (RYGB). The main points considered in the study's design and challenges faced in its application are detailed. Methods This observational, longitudinal, prospective study involved collection of gastrointestinal biopsy specimens, faeces, urine, and blood from 25 obese women with T2DM who were candidates for RYGB (20 patients for omics assessment and 5 for omics validation). These collections were performed preoperatively and 3 and 24 months postoperatively. Gastrointestinal transcriptomics; faecal metagenomics and metabolomics; plasma proteomics, lipidomics, and metabolomics; and biochemical, nutritional, and metabolic data were assessed to identify their short- and long-term correlations with T2DM remission. Results Data were collected from 20 patients before and 3 months after RYGB. These patients have nearly completed the 2-year follow-up assessments. The five additional patients are currently being selected for omics data validation. Conclusion The multi-integrated pan-omics approach of the SURMetaGIT study enables integrated analysis of data that will contribute to the understanding of molecular mechanisms involved in T2DM remission after RYGB.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Derivação Gástrica , Trato Gastrointestinal/metabolismo , Obesidade Mórbida/sangue , Proteoma/metabolismo , Transcriptoma , Adulto , Biópsia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/cirurgia , Diabetes Mellitus Tipo 2/urina , Fezes/química , Comportamento Alimentar , Feminino , Trato Gastrointestinal/fisiopatologia , Trato Gastrointestinal/cirurgia , Humanos , Estudos Longitudinais , Metaboloma , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Obesidade Mórbida/urina , Estudos Prospectivos , Proteoma/genética , Indução de Remissão , Projetos de Pesquisa , Redução de Peso
3.
Nutr Hosp ; 30(6): 1240-7, 2014 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-25433104

RESUMO

BACKGROUND: Nutritional and food intake assessments before and after bariatric surgery may be important to correct eating habits and nutritional deficiencies. AIM: To assess the efficiency of the 24-hour food recall (24hR) form as a fast method for assessing nutrient intake before and after a Roux-en-Y gastric bypass (RYGB). METHODS: This study analyzed data from 10 obese patients with type 2 diabetes mellitus (T2DM). Food intake (calories, macronutrients, and micronutrients) before and 3 months after RYGB were assessed with the 24hR as well as the seven-day food record (7dR) as the gold standard reference. Virtual Nutri Plus® software was used to quantify nutrients. RESULTS: The 7dR data revealed deficits in the estimated intake of total fiber and 14 out of 22 micronutrients pre- and postoperatively, combined; the 24hR failed to detect intake deficits in only two of these micronutrients (vitamins A and B3). Other postoperative deficits included carbohydrates, vitamin B1, copper, and iron, on which the 24hR was sensitive to only the iron deficit. In our pre- versus post-operative comparison analyses, the 7dR revealed decreases in total calories, carbohydrates, total and all subclasses of fat and fiber, and 12 micronutrients; in the analogous comparison analyses, the 24hR failed to detect decreases in the ingestion of monounsaturated and saturated fats and in six of these micronutrients. CONCLUSIONS: In obese T2DM patients, the 24hR performed reasonably well for probing nutrient intake before and after RYGB, but is not recommended for tracking changes over time, including pre- versus postoperative deficits.


Introducción: Las evaluaciones nutricionales y de ingesta de comida antes y después de cirugía bariátrica puede ser importante para corregir hábitos de alimentación y deficiencias nutricionales. Objetivo: Evaluar la eficacia del formulario de recordatorio de alimento de 24 horas (24hR) como método rápido de evaluación de ingesta de nutrientes antes y después de bypass gástrico en Y de Roux (RYGB). Métodos: Este estudio analizó datos de 10 pacientes obesos con diabetes mellitus de tipo 2 (T2DM). Se evaluó la ingesta de alimentos (calorías, macronutrientes y micronutrientes) antes y 3 meses después de RYGB con el 24hR además del registro de alimentos de siete días (7dR) como patrón de referencia estándar. Se utilizó el software Virtual Nutri Plus® para cuantificar los nutrientes. Resultados: Los datos del 7dR revelaron deficiencias en la ingesta estimada de fibra total y 14 de 22 micronutrientes pre- y postoperación, combinados; el 24hR no pudo detectar deficiencias de ingesta en solo dos de estos micronutrientes (vitaminas A y B3). Otras deficiencias postoperatorias incluyeron carbohidratos, vitamina B1, cobre y hierro, sobre las que el 24hR detectó solo la deficiencia de hierro. En nuestros análisis comparativos pre- y post-operación, el 7dR reveló descensos en calorías totales, carbohidratos, grasas totales y todas las subclasses de grasa y fibra, y 12 micronutrientes; en los análisis comparativos análogos, el 24hR no logró detectar descensos en la ingesta de grasas monoinsaturadas y saturadas y en seis de estos micronutrientes. Conclusiones: En pacientes obesos con T2DM, el 24hR funcionó razonablemente bien demostrando la ingesta de nutrientes antes y después de RYGB, pero no se recomienda para registrar cambios a lo largo del tiempo, incluyendo deficiencias pre- y postoperación.


Assuntos
Anastomose em-Y de Roux , Ingestão de Alimentos , Adolescente , Adulto , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/cirurgia , Registros de Dieta , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Software , Adulto Jovem
4.
Clinics (Sao Paulo) ; 69(11): 714-22, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25518027

RESUMO

OBJECTIVES: The assessment of nutritional intake before and after bariatric surgery assists in identifying eating disorders, nutritional deficiencies and weight loss/maintenance. The 7-day record is the gold standard for such an assessment and is interpreted using specialized software. This study sought to compare the Virtual Nutri Plus® and Dietpro 5i® software systems in assessing nutrient intake in obese patients with type 2 diabetes mellitus who underwent a Roux-en-Y gastric bypass. METHODS: Nutritional intake was assessed in 10 obese women with type 2 diabetes mellitus before and 3 months after Roux-en-Y gastric bypass. The 7-day record was used to assess food intake and then, the Virtual Nutri Plus® and Dietpro 5i® software systems were used to calculate calorie, macronutrient and micronutrient intake based on validated food chemical composition databases. Clinicaltrials.gov: NCT01251016. RESULTS: During the preoperative period, deficits in the ingestion of total fiber and 15 out of 22 estimated micronutrients were observed when using the Virtual Nutri Plus®, compared to deficiencies in total fiber and 4 micronutrients when using the Dietpro 5i®. During the postoperative period, both the Virtual Nutri Plus® and Dietpro 5i® systems detected deficits in the ingestion of total fiber, carbohydrates and 19 micronutrients, but only the Virtual Nutri Plus® detected deficits in complex B vitamins (except B12) and minerals. CONCLUSION: Virtual Nutri Plus® was more sensitive than Dietpro 5i® for the identification of deficits in nutrient intake in obese, type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass.


Assuntos
Ingestão de Alimentos , Derivação Gástrica/métodos , Avaliação Nutricional , Software , Adulto , Diabetes Mellitus Tipo 2 , Ingestão de Energia , Feminino , Humanos , Desnutrição/diagnóstico , Pessoa de Meia-Idade , Obesidade/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo
5.
Clinics ; 69(11): 714-722, 11/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-731112

RESUMO

OBJECTIVES: The assessment of nutritional intake before and after bariatric surgery assists in identifying eating disorders, nutritional deficiencies and weight loss/maintenance. The 7-day record is the gold standard for such an assessment and is interpreted using specialized software. This study sought to compare the Virtual Nutri Plus® and Dietpro 5i® software systems in assessing nutrient intake in obese patients with type 2 diabetes mellitus who underwent a Roux-en-Y gastric bypass. METHODS: Nutritional intake was assessed in 10 obese women with type 2 diabetes mellitus before and 3 months after Roux-en-Y gastric bypass. The 7-day record was used to assess food intake and then, the Virtual Nutri Plus® and Dietpro 5i® software systems were used to calculate calorie, macronutrient and micronutrient intake based on validated food chemical composition databases. Clinicaltrials.gov: NCT01251016. RESULTS: During the preoperative period, deficits in the ingestion of total fiber and 15 out of 22 estimated micronutrients were observed when using the Virtual Nutri Plus®, compared to deficiencies in total fiber and 4 micronutrients when using the Dietpro 5i®. During the postoperative period, both the Virtual Nutri Plus® and Dietpro 5i® systems detected deficits in the ingestion of total fiber, carbohydrates and 19 micronutrients, but only the Virtual Nutri Plus® detected deficits in complex B vitamins (except B12) and minerals. CONCLUSION: Virtual Nutri Plus® was more sensitive than Dietpro 5i® for the identification of deficits in nutrient intake in obese, type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass. .


Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Ingestão de Alimentos , Derivação Gástrica/métodos , Avaliação Nutricional , Software , Ingestão de Energia , Desnutrição/diagnóstico , Obesidade/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo
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