{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:12:01Z","timestamp":1793333521339,"version":"4.5.0"},"reference-count":37,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100007311","name":"Cleveland Clinic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007311","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004719","name":"LifeScan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004719","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["DK089547"],"award-info":[{"award-number":["DK089547"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005566","name":"Ethicon Endo-Surgery","doi-asserted-by":"publisher","award":["EES IIS 19900"],"award-info":[{"award-number":["EES IIS 19900"]}],"id":[{"id":"10.13039\/100005566","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are effective procedures to treat and manage type 2 diabetes (T2D). However, the underlying metabolic adaptations that mediate improvements in glucose homeostasis remain largely elusive. The purpose of this study was to identify metabolic signatures associated with biochemical resolution of T2D after medical therapy (MT) or bariatric surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Plasma samples from 90 patients (age 49.9 \u00b1 7.6 years; 57.7% female) randomly assigned to MT (n = 30), RYGB (n = 30), or SG (n = 30) were retrospectively subjected to untargeted metabolomic analysis using ultra performance liquid chromatography with tandem mass spectrometry at baseline and 24 months of treatment. Phenotypic importance was determined by supervised machine learning. Associations between change in glucose homeostasis and circulating metabolites were assessed using a linear mixed effects model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The circulating metabolome was dramatically remodeled after SG and RYGB, with largely overlapping signatures after MT. Compared with MT, SG and RYGB profoundly enhanced the concentration of metabolites associated with lipid and amino acid signaling, while limiting xenobiotic metabolites, a function of decreased medication use. Random forest analysis revealed 2-hydroxydecanoate as having selective importance to RYGB and as the most distinguishing feature between MT, SG, and RYGB. To this end, change in 2-hydroxydecanoate correlated with reductions in fasting glucose after RYGB but not SG or MT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>We identified a novel metabolomic fingerprint characterizing the longer-term adaptations to MT, RYGB, and SG. Notably, the metabolomic profiles of RYGB and SG procedures were distinct, indicating equivalent weight loss may be achieved by divergent effects on metabolism.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc24-0859","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T15:05:34Z","timestamp":1727103934000},"page":"2024-2032","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":15,"title":["Metabolomic Fingerprints of Medical Therapy Versus Bariatric Surgery in Patients With Obesity and Type 2 Diabetes: The STAMPEDE Trial"],"prefix":"10.2337","volume":"47","author":[{"given":"Christopher L.","family":"Axelrod","sequence":"first","affiliation":[{"name":"1Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH"},{"name":"2Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adithya","family":"Hari","sequence":"additional","affiliation":[{"name":"1Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wagner S.","family":"Dantas","sequence":"additional","affiliation":[{"name":"1Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH"},{"name":"2Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta R.","family":"Kashyap","sequence":"additional","affiliation":[{"name":"3Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip R.","family":"Schauer","sequence":"additional","affiliation":[{"name":"3Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH"},{"name":"4Clinical Metabolic Surgery Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7321-9917","authenticated-orcid":false,"given":"John P.","family":"Kirwan","sequence":"additional","affiliation":[{"name":"1Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH"},{"name":"2Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"2024102118515282900_B1","first-page":"1","article-title":"Prevalence of obesity and severe obesity among adults: United States, 2017\u20132018","volume":"360","author":"Hales","year":"2020","journal-title":"NCHS Data Brief"},{"key":"2024102118515282900_B2","unstructured":"Centers for Disease Control and Prevention\n          . 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