• Nutrition · Aug 2023

    Roux-en-Y gastric bypass affects the expression of genes related to the intestinal folate metabolism pathway in obese women.

    • Beatriz de Azevedo Muner Ferreira, Danielle Cristina Fonseca, Priscila Sala, Juliana Tepedino Martins Alves, Ana Paula Aguiar Prudêncio, Natasha Mendonça Machado, Mariane Marques, Samira Barcelos, Robson Kiyoshi Ishida, Ismael Francisco Mota Siqueira Guarda, De MouraEduardo Guimarães HourneauxEGHHospital das Clínicas, HCFMUSP, São Paulo, Brazil., Paulo Sakai, Marco Aurélio Santo, de Miranda TorrinhasRaquel Susana MatosRSMLaboratory 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., and 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. Electronic address: beatriz_azfe@hotmail.com.
    • Nutrition. 2023 Aug 1; 112: 112054112054.

    ObjectivesRoux-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.MethodsBiopsies 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.ResultsCompared 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).ConclusionThe 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.Copyright © 2023 Elsevier Inc. All rights reserved.

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