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de Azevedo Muner Ferreira B, Fonseca DC, Sala P, Alves JTM, Prudêncio APA, Machado NM, Marques M, Barcelos S, Ishida RK, Guarda IFMS, De Moura EGH, Sakai P, Santo MA, de Miranda Torrinhas RSM, Waitzberg DL. Roux-en-Y gastric bypass affects the expression of genes related to the intestinal folate metabolism pathway in obese women. Nutrition 2023; 112:112054. [PMID: 37224573 DOI: 10.1016/j.nut.2023.112054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/10/2023] [Accepted: 04/03/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Roux-en-Y gastric bypass (RYGB) promotes sustained weight loss, and the resulting new gastrointestinal anatomy can contribute to nutritional depletions. Folate deficiency is one of the most frequently observed nutritional deficiencies after RYGB. The aim of this study was to assess whether RYGB affects the expression of genes related to the intestinal folate metabolism pathway as an additional molecular mechanism contributing to its postoperative deficiency. METHODS Biopsies from the duodenum, jejunum, and ileum of 20 obese women were collected before and 3 mo after RYGB. The expression of genes involved in intestinal folate metabolism was assessed by microarray and reverse transcriptase polymerase chain reaction (RT-qPCR). Folate intake (7-d food record) and plasma levels (electrochemiluminescence) also were measured. RESULTS Compared with the preoperative phase, transcriptomic alterations were observed in all intestinal segments studied after RYBG, mainly marked by decreased expression of genes encoding folate transporters/receptors and increased expression of genes involved in folate biosynthesis (P < 0.05). Reduced folate intake and plasma folate levels were also observed simultaneously (P < 0.05). Plasma folate concentrations correlated inversely with intestinal FOLR2 and SHMT2 genes (P < 0.001). CONCLUSION The present findings suggested that impaired expression of genes related to intestinal folate metabolism may contribute to the early systemic deficiency after RYGB and highlight a potential transcriptomic reprogramming of the intestine in response to RYGB to compensate for folate depletion induced by this surgical technique.
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Affiliation(s)
- Beatriz de Azevedo Muner Ferreira
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Danielle Cristina Fonseca
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscila Sala
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Departmento de Nutrição, Centro Universitário São Camilo, Sao Paulo, Brazil
| | - Juliana Tepedino Martins Alves
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ana Paula Aguiar Prudêncio
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Natasha Mendonça Machado
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mariane Marques
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Samira Barcelos
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Paulo Sakai
- Hospital das Clínicas, HCFMUSP, São Paulo, Brazil
| | | | - Raquel Susana Matos de Miranda Torrinhas
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Dan Linetzky Waitzberg
- Laboratory of Nutrition and Metabolic Surgery of the Digestive Tract, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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