| 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 |
| Contributors: |
Medical Research Council (MRC); National Institute for Health Research; Fractyl Laboratories, Inc.; The Jon Moulton Charity Trust; Imperial College Healthcare NHS Trust |
| Source: |
2354 ; 2343 |
| Publisher Information: |
Elsevier |
| Publication Year: |
2020 |
| Collection: |
Imperial College London: Spiral |
| Subject Terms: |
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; Surgery; 1111 Nutrition and Dietetics |
| Description: |
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. |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
Clinical Nutrition; http://hdl.handle.net/10044/1/84861; G0902002; 12/10/04; 4581; Prof Alex Miras; FR717; FR420; WREE_P84939 |
| DOI: |
10.1016/j.clnu.2020.10.026 |
| Availability: |
http://hdl.handle.net/10044/1/84861; https://doi.org/10.1016/j.clnu.2020.10.026 |
| Rights: |
© 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/) ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.89CC5C48 |
| Database: |
BASE |