Metabolic surgery and endoscopy are associated with long-term reduction in body weight and amelioration of glucose control; however, exact mechanisms responsible for these effects remain unclear. We performed a complex serum proteomic analysis in obese subjects with type 2 diabetes mellitus undergoing endoscopic duodenal-jejunal by-pass liner implantation (DJBL) or gastric plication (GP) to identify potential factors involved in postprocedural metabolic improvements. Thirty-one obese diabetic subject - 20 undergoing DJBL implantation and 11 GP - were examined at baseline and 10 months after DJBL or 6 months after GP, respectively. Serum proteomic analysis was performed using LC-MS (liquid chromatography-mass spectrometry) and the results were compared with human Uniprot reference database. Both procedures resulted in reduction in body weight (BMI 41.5 ± 1.0 vs. 37.6 ± 1.0 kg/m2, p=0.01 for DJBL and 41.6 ± 1.1 vs. 35.4 ± 1.2 kg/m2, p<0.001 for GP) and HbA1C (72.5 ± 4.3 vs. 53.9 ± 3.3 mmol/mol, p=0.002 for DJBL and 55.4 ± 4.1 vs. 45.3 ± 2.3 mmol/mol, p=0.046 for GP). Proteomic analysis involving 600+ proteins revealed a significant change in 27 proteins after DJBL, including increase in IGFBP2, lyzosyme C and the islet cells regeneration factor lithostatine-1-α and decrease in C1q and serum amyloid A4. GP was associated with a change in 13 proteins including elevation of paraoxonase 1 and reduction of matrix metalloproteinase 2. To conclude, despite better weight-reducing efficacy of GP DJBL had a more profound effect on serum proteome, which might at least partially explain the stronger reduction in HbA1C observed in DJBL.


M. Mraz: None. K. Harant: None. H. Kratochvilova: None. A. Cinkajzlova: None. J. Klouckova: None. P. Kaválková: None. Z. Lacinová: None. M. Benes: None. Z. Vlasakova: None. K. Dolezalova: None. M. Fried: None. T. Pelikanova: None. M. Haluzik: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at