{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T17:45:59Z","timestamp":1763142359441,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K08DK125878","R01DK108642","R56DK125816"],"award-info":[{"award-number":["K08DK125878","R01DK108642","R56DK125816"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We have previously shown that early intestinal adaptation precedes and relates to metabolic improvement in humans after Roux\u2010en\u2010Y gastric bypass surgery (RYGB). We hypothesized that intestinal adaptation would persist at the 1\u2010year postoperative time point and that gene expression (GE) signatures would relate to type 2 diabetes remission, providing insight into potential mechanisms for intestinally mediated metabolic improvement after RYGB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined GE by RNA sequencing in jejunum (Roux limb [RL]) collected from 28 patients before and 12\u2009months after RYGB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Global GE from paired baseline and 1\u2010year jejunal samples did not separate according to clinical phenotype (type 2 diabetes\u00a0remission, sustained weight loss). In general, GE was consistent with persistent RL remodeling, and microvilli were elongated by 39%. Remodeling was not attenuated in patients with lack of diabetes remission or with weight regain. Patients with diabetes remission demonstrated greater jejunal activation of lipogenesis\u2010related pathways driven by RXR, LXR, and SREBP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RL adaptation is a key feature of RYGB in all patients, likely reflecting the dramatic alterations to gastrointestinal anatomy, but jejunal lipogenesis appears to be more strongly activated in those patients with diabetes remission. Further study is needed to understand whether these pathways may drive metabolic remission after RYGB.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.24135","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T05:25:36Z","timestamp":1729056336000},"page":"2135-2148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gastric bypass elicits persistent gut adaptation and unique diabetes remission\u2010related metabolic gene regulation"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4767-868X","authenticated-orcid":false,"given":"Margaret A.","family":"Stefater\u2010Richards","sequence":"first","affiliation":[{"name":"Division of Endocrinology Boston Children's Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Panciotti","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Esteva","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Lerner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carter R.","family":"Petty","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Design Center Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William F.","family":"Gourash","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita P.","family":"Courcoulas","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania 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