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The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids

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Title: The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids
Authors: Glaysher, M
Ward, J
Aldhwayan, M
Ruban, A
Prechtl, CG
Fisk, HL
Chhina, N
Al-Najim, W
Smith, C
Klimowska-Nassar, N
Johnson, N
Falaschetti, E
Goldstone, AP
Miras, AD
Byrne, JP
Calder, PC
Teare, J
Item Type: Journal Article
Abstract: Background & aims Duodenal-jejunal bypass liners (DJBLs) prevent absorption in the proximal small intestine, the site of fatty acid absorption. We sought to investigate the effects of a DJBL on blood concentrations of essential fatty acids (EFAs) and bioactive polyunsaturated fatty acids (PUFAs). Methods Sub-study of a multicentre, randomised, controlled trial with two treatment groups. Patients aged 18–65 years with type-2 diabetes mellitus and body mass index 30–50 kg/m2 were randomised to receive a DJBL for 12 months or best medical therapy, diet and exercise. Whole plasma PUFA concentrations were determined at baseline, 10 days, 6 and 11.5 months; data were available for n = 70 patients per group. Results Weight loss was significantly greater in the DJBL group compared to controls after 11.5 months: total body weight loss 11.3 ± 5.3% versus 6.0 ± 5.7% (mean difference [95% CI] = 5.27% [3.75, 6.80], p < 0.001). Absolute concentrations of both EFAs, linoleic acid and α-linolenic acid, and their bioactive derivatives, arachidonic acid, eicosapentaenoic acid, docosapentaenoic acid and docosahexaenoic acid, were significantly lower in the DJBL group than in the control group at 6 and 11.5 months follow-up. Total serum cholesterol, LDL-cholesterol and HDL-cholesterol were also significantly lower in the DJBL group. Conclusion One year of DJBL therapy is associated with superior weight loss and greater reductions in total serum cholesterol and LDL-cholesterol, but also depletion of EFAs and their longer chain derivatives. DJBL therapy may need to be offset by maintaining an adequate dietary intake of PUFAs or by supplementation.
Issue Date: Apr-2021
Date of Acceptance: 16-Oct-2020
URI: http://hdl.handle.net/10044/1/84861
DOI: 10.1016/j.clnu.2020.10.026
ISSN: 0261-5614
Publisher: Elsevier
Start Page: 2343
End Page: 2354
Journal / Book Title: Clinical Nutrition
Volume: 40
Issue: 4
Copyright Statement: © 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Sponsor/Funder: Medical Research Council (MRC)
National Institute for Health Research
Fractyl Laboratories, Inc.
The Jon Moulton Charity Trust
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust
The Jon Moulton Charity Trust
Funder's Grant Number: G0902002
12/10/04
4581
Prof Alex Miras
FR717
FR420
WREE_P84939
Keywords: Science & Technology
Life Sciences & Biomedicine
Nutrition & Dietetics
Endobarrier
Duodenal-jejunal bypass liner
Endoscopic bariatric therapies
Obesity
Lipids
Polyunsaturated fatty acids
LIFE-STYLE INTERVENTION
BARIATRIC SURGERY
WEIGHT-LOSS
GLYCEMIC CONTROL
OBESE-PATIENTS
METABOLIC THERAPIES
TYPE-2
REDUCTION
IMPROVEMENT
OUTCOMES
Science & Technology
Life Sciences & Biomedicine
Surgery
Duodenal-jejunal bypass liner
Endobarrier
Endoscopic bariatric therapies
Lipids
Obesity
Polyunsaturated fatty acids
1111 Nutrition and Dietetics
Nutrition & Dietetics
Publication Status: Published
Online Publication Date: 2020-10-22
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Department of Surgery and Cancer
Faculty of Medicine
School of Public Health
Department of Brain Sciences



This item is licensed under a Creative Commons License Creative Commons