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.

Disclosure

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.

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