Urinary Metabolomic Changes Accompanying Albuminuria Remission following Gastric Bypass Surgery for Type 2 Diabetic Kidney Disease

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Title: Urinary Metabolomic Changes Accompanying Albuminuria Remission following Gastric Bypass Surgery for Type 2 Diabetic Kidney Disease
Authors: Martin, William P.Malmodin, DanielPedersen, AndersWallace, Martinale Roux, Carel W.Docherty, Neil G.et al.
Permanent link: http://hdl.handle.net/10197/12760
Date: 2-Feb-2022
Online since: 2022-02-15T09:40:17Z
Abstract: In the Microvascular Outcomes after Metabolic Surgery randomised clinical trial (MOMS RCT, NCT01821508), combined metabolic surgery (gastric bypass) plus medical therapy (CSM) was superior to medical therapy alone (MTA) as a means of achieving albuminuria remission at 2-year follow-up in patients with obesity and early diabetic kidney disease (DKD). In the present study, we assessed the urinary 1H-NMR metabolome in a subgroup of patients from both arms of the MOMS RCT at baseline and 6-month follow-up. Whilst CSM and MTA both reduced the urinary excretion of sugars, CSM generated a distinctive urinary metabolomic profile characterised by increases in host–microbial co-metabolites (N-phenylacetylglycine, trimethylamine N-oxide, and 4-aminobutyrate (GABA)) and amino acids (arginine and glutamine). Furthermore, reductions in aromatic amino acids (phenylalanine and tyrosine), as well as branched-chain amino acids (BCAAs) and related catabolites (valine, leucine, 3-hydroxyisobutyrate, 3-hydroxyisovalerate, and 3-methyl-2-oxovalerate), were observed following CSM but not MTA. Improvements in BMI did not correlate with improvements in metabolic and renal indices following CSM. Conversely, urinary metabolites changed by CSM at 6 months were moderately to strongly correlated with improvements in blood pressure, glycaemia, triglycerides, and albuminuria up to 24 months following treatment initiation, highlighting the potential involvement of these shifts in the urinary metabolomic profile in the metabolic and renoprotective effects of CSM.
Funding Details: Health Research Board
Health Service Executive
Science Foundation Ireland -- replace
Wellcome Trust
Funding Details: Johnson & Johnson Brasil
Oswaldo Cruz German Hospital
Swedish Medical Research Council
European Foundation for the Study of Diabetes/Boehringer Ingelheim European Diabetes Research Programme
Health and Social Care, Research and Development Division, Northern Ireland
Type of material: Journal Article
Publisher: MDPI
Journal: Metabolites
Volume: 12
Issue: 2
Copyright (published version): 2022 the Authors
Keywords: ObesityKidney DiseaseDiabetesPreventionNutritionRenal and urogenitalMetabolic and endocrine
DOI: 10.3390/metabo12020139
Language: en
Status of Item: Peer reviewed
ISSN: 2218-1989
This item is made available under a Creative Commons License: https://creativecommons.org/licenses/by/3.0/ie/
Appears in Collections:Conway Institute Research Collection
Institute of Food and Health Research Collection
Medicine Research Collection
Agriculture and Food Science Research Collection

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