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SERPINE-1 Gene Methylation and Protein as Molecular Predictors of Laparoscopic Sleeve Gastrectomy Outcome

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Abstract

Background

Body weight is subjected to genetic and epigenetic modifiers that might affect the success of weight loss interventions. Because of its possible complications and disparity in patients’ response, identification of predictors to the outcome of bariatric surgery is indispensable.

Objectives

This prospective study aims to investigate serpin peptidase inhibitor type 1 (SERPINE-1) protein and gene methylation as molecular predictors to the outcome of bariatric surgery.

Patients and Methods

One hundred participants were enrolled and divided to control group (n = 50) and obese patients who underwent laparoscopic sleeve gastrectomy (LSG) (n = 50). Anthropometric measurements were assessed and blood samples were collected preoperatively and 6 months postoperatively for assessment of SERPINE-1 protein and gene methylation, C-reactive protein (CRP), and homeostatic model assessment of insulin resistance (HOMA-IR). Moreover, subjects were followed for 2 years for weight loss parameters.

Results

Patients with obesity showed high baseline SERPINE-1 protein and gene hypermethylation where LSG was followed by a drop in SERPINE-1 protein level but not gene hypermethylation. Baseline SERPINE-1 gene methylation was negatively related to postoperative weight loss and was the independent predictor to weight loss after LSG. Likewise, postoperative SERPINE-1 protein was negatively related to weight loss with independent expression from its gene methylation state. Furthermore, postoperative SERPINE-1 gene methylation correlated to CRP and HOMA-IR.

Conclusion

Baseline SERPINE-1 gene methylation might be a predictor of weight loss after LSG. Meanwhile, postoperative SERPINE-1 protein could be a predictor to weight loss maintenance after LSG. Lastly, postoperative SERPINE-1 gene methylation might serve as an index to postoperative changes in obesity-related comorbidities.

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Authors and Affiliations

  1. Department of Medical Biochemistry, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Sara Assem, Safaa H. Mohy-El Dine, Amel F. Ketat & Doaa A. Abdelmonsif

  2. Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Tamer N. Abdelbaki

  3. Molecular Biology Lab. and Nanomedicine Lab., Center of Excellence for Research in Regenerative Medicine and Applications, University of Alexandria, Alexandria, Egypt

    Doaa A. Abdelmonsif

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  1. Sara Assem
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  2. Tamer N. Abdelbaki
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All authors declare that they have substantially contributed to the manuscript and have met the main criteria of authorship: conceptualization, methodology, data collecting and processing, writing and editing, and supervision.

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Correspondence to Doaa A. Abdelmonsif.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Assem, S., Abdelbaki, T.N., Mohy-El Dine, S.H. et al. SERPINE-1 Gene Methylation and Protein as Molecular Predictors of Laparoscopic Sleeve Gastrectomy Outcome. OBES SURG 30, 2620–2630 (2020). https://doi.org/10.1007/s11695-020-04533-0

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