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Small Intestinal Length Associates with Serum Triglycerides Before and After LRYGB

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A Correction to this article was published on 14 December 2021

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Abstract

Background and Aims

Different bariatric procedures have been associated with variable weight loss and decrease in serum levels of lipids and lipoproteins. This variation could be partly related to the length of the small intestinal bypass. We evaluated the association of the small intestinal length with the non-alcoholic fatty liver disease (NAFLD) at baseline and with lipid metabolism before and after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods

Seventy consecutive morbidly obese patients were recruited to this prospective study. A standard 60-cm biliopancreatic limb (BPL) and 120-cm alimentary limb (AL) was performed, and thereafter, the common channel (CC) length was measured during elective LRYGB. Histological analysis of liver biopsy to diagnose NAFLD was performed. The mRNA expression of genes participating in the cholesterol and fatty acid metabolism in the liver was analyzed.

Results

Female sex (p = 0.006), serum triglycerides (TG, p = 0.016), serum alanine aminotransferase (ALT, p = 0.007), and liver steatosis (p = 0.001) associated with the small intestinal length (BPL + AL + CC) at baseline. Association remained significant between levels of serum TG and CC length (p = 0.048) at 1-year follow-up. Liver mRNA expression of genes regulating cholesterol synthesis and bile metabolism did not associate with the baseline small intestinal length.

Conclusions

Our findings support the suggestions that small intestinal length regulates TG metabolism before and after LRYGB. Therefore, modification of the length of bypassed small intestine based on measured total small intestinal length could optimize the outcomes of the elective LRYGB.

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Acknowledgments

We thank Matti Laitinen and Päivi Turunen for their careful work in patient recruitment and laboratory analyses.

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Authors and Affiliations

  1. Department of Surgery, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland

    Pirjo Käkelä, Sari Venesmaa & Hannu Paajanen

  2. Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland

    Ville Männistö

  3. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210, Kuopio, Finland

    Maija Vaittinen & Jussi Pihlajamäki

  4. Department of Pathology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland

    Vesa Kärjä

  5. Department of Clinical Nutrition and Obesity Centre, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland

    Kirsi Virtanen & Jussi Pihlajamäki

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  1. Pirjo Käkelä
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Corresponding author

Correspondence to Jussi Pihlajamäki.

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Study was approved by the Ethics Committee of the Northern Savo Hospital District (54/2005, 104/2008 and 27/2010).

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

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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Käkelä, P., Männistö, V., Vaittinen, M. et al. Small Intestinal Length Associates with Serum Triglycerides Before and After LRYGB. OBES SURG 28, 3969–3975 (2018). https://doi.org/10.1007/s11695-018-3447-x

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