| Autor: |
Sampaio P; Centro Universitário São Camilo, São Paulo, Brazil.; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Waitzberg DL; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Machado NM; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., de Miranda Torrinhas RSM; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Fonseca DC; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Ferreira BAM; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Marques M; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Barcelos S; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil., Ishida RK; Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil., Guarda IFMS; Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil., de Moura EGH; Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil., Sakai P; Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil., Santo MA; Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil., Heymsfield SB; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Corrêa-Giannella ML; Laboratorio de Carboidratos e Radioimunoensaio (LIM-18) do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, University of São Paulo, Brazil., Passadore MD; Centro Universitário São Camilo, São Paulo, Brazil., Sala P; Centro Universitário São Camilo, São Paulo, Brazil.; Department of Gastroenterology, Digestive Surgery Discipline, School of Medicine, University of São Paulo (LIM 35), Brazil. |
| Abstrakt: |
Roux-en-Y gastric bypass (RYGB) is one of the most performed bariatric surgical techniques. However, RYGB commonly results, as side effects, in nutritional deficiencies. This study aimed to examine changes in the expression of vitamin A pathway encoding genes in the gastrointestinal tract (GI) and to evaluate the potential mechanisms associated with hypovitaminosis A after RYGB. Intestinal biopsies were obtained through double-balloon endoscopy in 20 women with obesity (age 46.9±6.2 years; body mass index [BMI] 46.5±5.3 kg/m 2 [mean±SD]) before and three months after RYGB (BMI, 38.2±4.2 kg/m 2 ). Intestinal mucosal gene microarray analyses were performed in samples using a Human GeneChip 1.0 ST array (Affymetrix). Vitamin A intake was assessed from 7-day food records and serum retinol levels were evaluated by electrochemiluminescence immunoassay. Our results showed the following genes with significant downregulation (p≤0.05): LIPF (-0.60), NPC1L1 (-0.71), BCO1 (-0.45), and RBP4 (-0.13) in the duodenum; CD36 (-0.33), and ISX (-0.43) in the jejunum and BCO1 (-0.29) in the ileum. No significant changes in vitamin A intake were found (784±694 retinol equivalents [RE] pre-operative vs. 809±753 RE post-operative [mean±SD]). Although patients were routinely supplemented with 3500 international units IU/day (equivalent to 1050 μg RE/day) of oral retinol palmitate, serum concentrations were lower in the post-operative when compared to pre-operative period (0.35±0.14 μg/L vs. 0.52±0.33 μg/L, respectively - P=0.07), both within the normal range. After RYGB, the simultaneous change in expression of GI genes, may impair carotenoid metabolism in the enterocytes, formation of nascent chylomicrons and transport of retinol, resulting in lower availability of vitamin A. |
