Long-term changes in adipose tissue gene expression following bariatric surgery

Area of Science:

• Metabolic Surgery
• Adipose Tissue Biology
• Gene Expression Profiling

Background:

• Bariatric surgery offers sustained metabolic benefits and reduced type 2 diabetes risk.
• Weight regain occurs long-term after bariatric procedures.
• Altered gene expression in white adipose tissue (WAT) may mediate these protective effects.

Purpose of the Study:

• To investigate long-term changes in WAT gene expression after Roux-en-Y gastric bypass (RYGB).
• To determine if these gene expression changes correlate with metabolic improvements or weight regain.

Main Methods:

• Transcriptomic profiling using gene microarrays on abdominal subcutaneous WAT.
• Samples collected from women before, 2 years, and 5 years after RYGB.
• Comparison with age-matched non-operated control women.

Main Results:

• Significant weight loss (38 kg) at 2 years post-RYGB, followed by 8 kg regain by 5 years.
• Most WAT gene expression changes occurred within the first 2 years.
• A subset of inflammation-related genes showed continuous downregulation from baseline to 5 years, independent of weight regain.

Conclusions:

• Sustained downregulation of inflammatory gene expression in WAT post-bariatric surgery may contribute to long-term metabolic benefits.
• These persistent changes in WAT gene expression are independent of body weight fluctuations.
• Altered inflammatory gene expression may underlie sustained improvements in adipose tissue morphology.