Prediction of glycated hemoglobin levels at 3 months after metabolic surgery based on the 7-day plasma metabolic profile

• Published in: PloS one Vol. 9; no. 11; p. e109609
• Main Authors: Kwon, Hyuk Nam, Lee, Yeon Ji, Kang, Ju-Hee, Choi, Ji-Ho, An, Yong Jin, Kang, Sunmi, Lee, Dae Hyun, Suh, Young Ju, Heo, Yoonseok, Park, Sunghyouk
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.11.2014; Public Library of Science (PLoS)
• Subjects: Bariatric Surgery - statistics & numerical data; Biology and Life Sciences; Biomarkers - blood; Correlation; Diabetes mellitus; Diabetes Mellitus, Type 2 - surgery; Diabetes therapy; Gastrointestinal surgery; Glucose; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - metabolism; Glycosylated hemoglobin; Hemoglobin; Humans; Least-Squares Analysis; Magnetic Resonance Spectroscopy; Markers; Medicine and Health Sciences; Metabolites; Metabolomics; Metabolomics - methods; Models, Biological; NMR; Nuclear magnetic resonance; Obesity; Patients; Predictions; Prognosis; Regression analysis; Republic of Korea; Surgery; Time Factors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0109609

Metabolic surgery has been shown to provide better glycemic control for type 2 diabetes than conventional therapies. Still, the outcomes of the surgery are variable, and prognostic markers reflecting the metabolic changes by the surgery are yet to be established. NMR-based plasma metabolomics followed by multivariate regression was used to test the correlation between the metabolomic profile at 7-days after surgery and glycated hemoglobin (HbA1c) levels at 3-months (and up to 12 months with less patients), and to identify the relevant markers. Metabolomic profiles at 7-days could differentiate the patients according to the HbA1c improvement status at 3-months. The HbA1c values were predicted based on the metabolomics profile with partial least square regression, and found to be correlated with the observed values. Metabolite analysis suggested that 3-Hydroxybutyrate (3-HB) and glucose contributes to this prediction, and the [3-HB]/[glucose] exhibited a modest to good correlation with the HbA1c level at 3-months. The prediction of 3-month HbA1c using 7-day metabolomic profile and the suggested new criterion [3-HB]/[glucose] could augment current prognostic modalities and help clinicians decide if drug therapy is necessary.