Gastrointestinal genetic reprogramming of vitamin A metabolic pathways in response of Roux-en-Y gastric bypass

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/m2 [mean±SD]) before and three months after RYGB (BMI, 38.2±4.2 kg/m2). 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.

Effects of ageing on the energy balance of food-restricted rats

AIMS

Age can alter energy balance by decreasing the resting metabolic rate. Food restriction can also change energy balance by decreasing energy expenditure as a mechanism of energy conservation. We investigated the influence of food restriction on the energy balance of rats at different ages.

METHODS

Wistar EPM-1 female rats were used at ages of 3, 9, 15 and 21 months. At each age, two food intake schedules were provided: control (ad libitum) and food restriction (50%). Animals remained under these schedules for 30 days, and throughout this period body weight, food intake, and stool collection were controlled daily. On the 30th day, animals were killed, blood was collected and the carcasses and faeces were processed for analysis by pump calorimetry. Blood glucose, T(3), T(4) and rT(3) levels were determined.

RESULTS

Food restriction reduced energy gain and gross food efficiency of animals at different ages, but more so in older animals. Food-restricted rats also had lower energy expenditure than controls. This reduction was about 40% of the energy expenditure of control animals irrespective of age. Water content increased and fat content decreased in the carcass of food-restricted animals. Serum T(3) and T(4) levels were lower in food-restricted animals pointing out to a major role of thyroid hormones in the mechanism of energy conservation exhibited by food-restricted animals.

CONCLUSIONS

The mechanism of energy conservation takes place in all restricted animals and is very important for survival and for species preservation, mainly in aged animals in which food restriction is frequently aggravated by senescence-related organic disorders.