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The impact of bariatric surgery on serum tryptophan-kynurenine pathway metabolites

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Title: The impact of bariatric surgery on serum tryptophan-kynurenine pathway metabolites
Authors: Yeung, KTD
Penney, N
Whiley, L
Ashrafian, H
Lewis, M
Purkayastha, S
Darzi, A
Holmes, E
Item Type: Journal Article
Abstract: Objectives: This study aims to explore the immediate effects of bariatric surgery on serum tryptophan – kynurenine pathway metabolites in individuals with type 2 diabetes and BMI >30. With the goal of providing insight into the link between tryptophan pathway metabolites, type 2 diabetes, and chronic obesity-induced inflammation. Methods: This longitudinal study included 20 participants. Half were diagnosed with type 2 diabetes. 11 and 9 underwent RYGB and SG respectively. Blood samples were obtained at pre-operative and three months post-operative timepoints. Tryptophan and downstream metabolites of the kynurenine pathway were quantified with an ultrahigh-performance liquid chromatography tandem mass spectrometry with electrospray ionisation method. Results: At 3 months post-operation, RYGB led to significant reductions in tryptophan, kynurenic acid and xanthurenic acid levels when compared to baseline. Significant reductions of the same metabolites after surgery were also observed in individuals with T2D irrespective of surgical procedure. These metabolites were significantly correlated with serum HbA1c levels and BMI. Conclusions: Bariatric surgery, in particular RYGB reduces serum levels of tryptophan and its downstream kynurenine metabolites. These metabolites are associated with T2D and thought to be potentially mechanistic in the systemic processes of obesity induced inflammation leading to insulin resistance. Its reduction after surgery is associated with an improvement in glycaemic control (HbA1c).
Issue Date: 7-Jan-2022
Date of Acceptance: 3-Dec-2021
URI: http://hdl.handle.net/10044/1/93193
ISSN: 2045-2322
Publisher: Nature Publishing Group
Journal / Book Title: Scientific Reports
Volume: 12
Copyright Statement: ©The Author(s) 2022
Sponsor/Funder: National Institute of Health Research
Publication Status: Published online
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Department of Surgery and Cancer
Faculty of Medicine
Institute of Global Health Innovation

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