The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids
The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids
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/m
2 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. Trial registration: ClinicalTrials.gov Identifier NCT02459561.
Duodenal-jejunal bypass liner, Endobarrier, Endoscopic bariatric therapies, Lipids, Obesity, Polyunsaturated fatty acids
Glaysher, Michael
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Ward, James
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Aldhwayan, Madhawi
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Ruban, Aruchuna
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Prechtl,, Christina Gabriele
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Fisk, Helena
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Chhina, Navpreet
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Al-Najim, Werd
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Smith, Claire
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Klimowska-Nassar, Natalia
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Johnson, Nicholas
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Falaschetti, Emmanuela
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Goldstone, Anthony P.
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Miras, Alexander Dimitri
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Byrne, James
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Calder, Philip
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Teare, Julian P
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12 April 2021
Glaysher, Michael
965e02e5-5f16-4173-a507-2423fce132ad
Ward, James
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Aldhwayan, Madhawi
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Ruban, Aruchuna
491af67b-a027-4017-8aa5-fd2f0b91dd97
Prechtl,, Christina Gabriele
2ae9edaa-b948-44e7-a61e-ac2f095354ec
Fisk, Helena
2483d346-75dd-41b3-a481-10f8bb39cd9f
Chhina, Navpreet
cdb47d66-baa0-4783-a1b0-77ddfc52ea88
Al-Najim, Werd
c93a3d26-0f3a-4878-b2d7-44b1ef463b8d
Smith, Claire
0260d7df-710e-4ad5-ab85-fd186baa7b79
Klimowska-Nassar, Natalia
3f43d195-d42a-4e7c-8c88-8c30879eb25f
Johnson, Nicholas
59098de9-7372-4102-b7ec-3e188dd881af
Falaschetti, Emmanuela
2091d7b3-ee2c-4140-be61-275e895a4177
Goldstone, Anthony P.
3025a558-e46b-4ad9-a9c1-d7a73021c253
Miras, Alexander Dimitri
11d917d8-c0fc-4c22-8600-9af978668fb1
Byrne, James
e3d5b8fe-1b69-441c-a173-e084fe5372a6
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Teare, Julian P
1cabe3fd-2b30-4ba1-892a-05fc21c48903
Glaysher, Michael, Ward, James, Aldhwayan, Madhawi, Ruban, Aruchuna, Prechtl,, Christina Gabriele, Fisk, Helena, Chhina, Navpreet, Al-Najim, Werd, Smith, Claire, Klimowska-Nassar, Natalia, Johnson, Nicholas, Falaschetti, Emmanuela, Goldstone, Anthony P., Miras, Alexander Dimitri, Byrne, James, Calder, Philip and Teare, Julian P
(2021)
The effect of a duodenal-jejunal bypass liner on lipid profile and blood concentrations of long chain polyunsaturated fatty acids.
Clinical Nutrition.
(doi:10.1016/j.clnu.2020.10.026).
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/m
2 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. Trial registration: ClinicalTrials.gov Identifier NCT02459561.
Text
Endobarrier PUFA Clin Nutr - revision 2 clean
- Accepted Manuscript
More information
Accepted/In Press date: 16 October 2020
e-pub ahead of print date: 22 October 2020
Published date: 12 April 2021
Additional Information:
Acknowledgements
The trial was funded by the Efficacy and Mechanism Evaluation
(EME) Programme, a Medical Research Council and National Insti-
tute for Health Research (NIHR) partnership. This paper presents
independent research funded by the EME Programme and sup-
ported by the NIHR Clinical Research Facilities and Biomedical
Research Centres at Imperial College Healthcare NHS Trust and
University Hospital Southampton NHS Foundation Trust.
Keywords:
Duodenal-jejunal bypass liner, Endobarrier, Endoscopic bariatric therapies, Lipids, Obesity, Polyunsaturated fatty acids
Identifiers
Local EPrints ID: 444655
URI: http://eprints.soton.ac.uk/id/eprint/444655
ISSN: 0261-5614
PURE UUID: b0530b24-7ed2-4596-8441-8649ed631fa8
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Date deposited: 28 Oct 2020 18:03
Last modified: 17 Mar 2024 03:30
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Contributors
Author:
Michael Glaysher
Author:
James Ward
Author:
Madhawi Aldhwayan
Author:
Aruchuna Ruban
Author:
Christina Gabriele Prechtl,
Author:
Helena Fisk
Author:
Navpreet Chhina
Author:
Werd Al-Najim
Author:
Claire Smith
Author:
Natalia Klimowska-Nassar
Author:
Nicholas Johnson
Author:
Emmanuela Falaschetti
Author:
Anthony P. Goldstone
Author:
Alexander Dimitri Miras
Author:
James Byrne
Author:
Julian P Teare
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