Depot-specific molecular remodelling of human adipose tissue and liver following bariatric surgery revealed by longitudinal multi-omic profiling.
Niall J Dempster, Frederik Steensgaard Gade, Charlotte Daly et al.
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In 30 seconds
This randomised, prospective, longitudinal study followed women living with obesity for 1 year during a low-calorie diet followed by sleeve gastrectomy or Roux-en-Y gastric bypass, with a non-obese control group. Repeated clinical, imaging, meal-test and multi-omic assessments examined metabolic phenotype and liver and adipose tissue changes. Surgery was associated with normalized non-invasive liver assessments and reduced body fat, particularly android rather than gynoid fat. Molecular changes were seen in abdominal but not gluteal adipose tissue. Clinical and molecular outcomes did not differ significantly between the two surgical procedures.
Key findings
- Bariatric surgery was associated with normalization of non-invasive assessments of liver phenotype.
- Body fat decreased, with greater change in android than gynoid fat mass.
- Proteomic changes occurred in abdominal adipose tissue but were not observed in gluteal adipose tissue.
- Clinical and molecular outcomes did not differ significantly between sleeve gastrectomy and Roux-en-Y gastric bypass.
Why it matters
The findings suggest that metabolic improvement after bariatric surgery may involve distinct responses across adipose tissue depots, rather than uniform remodelling. The accompanying liver and molecular changes help characterize these responses and identify candidate pathways for further study, while the lack of significant differences between procedures provides no evidence here of distinct molecular or clinical outcomes by operation.
What to keep in mind
The study was limited to women living with obesity and followed participants for 1 year; the abstract does not report sample size or longer-term outcomes.