{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:23:48Z","timestamp":1785435828165,"version":"3.56.0"},"reference-count":50,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Medicine, Corewell Health William Beaumont University Hospital"},{"id":[{"id":"https:\/\/ror.org\/058sakv40","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Fred A. & Barbara M. Erb Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background\/Objectives: Metabolomics has emerged as a tool to gain insight into the body\u2019s biological responses to therapeutic interventions. Bariatric surgery remains the most effective treatment for severe obesity and associated comorbidities, leading to significant weight and metabolic improvements. Using a multi-platform, multi-compartment metabolomics approach, this study systematically characterizes longitudinal changes in fecal and serum metabolomes of 45 patients following sleeve gastrectomy (SG). Participants were stratified by weight loss outcomes to identify metabolic signatures associated with differential responses, which may serve as predictors of weight loss and provide mechanistic insights in developing targeted therapeutic strategies. Methods: Metabolomic and lipidomic responses to SG were analyzed using multivariable linear mixed-effects models based on data collected pre-operatively and at 3 and 12 months post-operatively. Results: The percentage total weight loss for the highest versus lowest weight loss tertiles (T3 vs. T1) at twelve months was 35.81 + 5.4% and 19.49 + 2.62%, p &lt; 0.001, respectively. Substantial alterations in fecal metabolites and lipid species were observed among T3 after twelve months, including aspartate, tyrosine, carnitine, glycine, PC.ae.C36.4, PC.aa.C38.0, PC.ae.C44.4, PC.ae.C40.2, and PC.aa.C40:5. Specifically, changes in serum lipid species including SM.OH.C22:1, PC.ae.C32:1, PC.aa.C34:4, PC.aa.C36:6, PC.ae.C34:3, PC.ae.C34:1, and PC.ae.C32:2, support serum lipidomics as a minimally invasive marker of gut remodeling and adaptation following SG. Sex-stratified analysis revealed unique fecal and serum metabolic changes, highlighting the significance of personalized metabolic monitoring and obesity treatment. Conclusions: Our findings identify metabolic alterations associated with response variability following SG and highlight the potential utility of machine learning to predict weight-loss trajectories and inform personalized interventions.<\/jats:p>","DOI":"10.3390\/metabo16070497","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:34:23Z","timestamp":1784172863000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Assessment of Twelve-Month Weight Loss Outcomes Post-Sleeve Gastrectomy: The Role of Serum and Fecal Metabolomic Biomarkers"],"prefix":"10.3390","volume":"16","author":[{"given":"Maya","family":"Nassif","sequence":"first","affiliation":[{"name":"Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA"},{"name":"Corewell Health William Beaumont University Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn M.","family":"Ziegler","sequence":"additional","affiliation":[{"name":"Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA"},{"name":"Corewell Health William Beaumont University Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Ashrafi","sequence":"additional","affiliation":[{"name":"Corewell Health Research Institute, 3811 W 13 Mile Rd, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8513-1521","authenticated-orcid":false,"given":"Romana Mimi","family":"Ashrafi","sequence":"additional","affiliation":[{"name":"Corewell Health Research Institute, 3811 W 13 Mile Rd, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Khalid","sequence":"additional","affiliation":[{"name":"Corewell Health Research Institute, 3811 W 13 Mile Rd, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeyya","family":"Akyol","sequence":"additional","affiliation":[{"name":"Corewell Health Research Institute, 3811 W 13 Mile Rd, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Idler","sequence":"additional","affiliation":[{"name":"West Penn Hospital, Allegheny Health Network, 4815 Liberty Ave, Suite GR50, Pittsburgh, PA 15224, USA"},{"name":"Drexel University College of Medicine, 2900 W Queen Ln, Philadelphia, PA 19129, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milda","family":"Mil\u010di\u016bt\u0117","sequence":"additional","affiliation":[{"name":"VUGENE, LT-10312 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilija","family":"Lomeikait\u0117","sequence":"additional","affiliation":[{"name":"VUGENE, LT-10312 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9495-1859","authenticated-orcid":false,"given":"Aust\u0117ja","family":"Jankevi\u010di\u016bt\u0117","sequence":"additional","affiliation":[{"name":"VUGENE, LT-10312 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Sims","sequence":"additional","affiliation":[{"name":"Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA"},{"name":"Corewell Health William Beaumont University Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073, USA"},{"name":"Corewell Health Research Institute, 3811 W 13 Mile Rd, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2056-5573","authenticated-orcid":false,"given":"Michael E.","family":"Maddens","sequence":"additional","affiliation":[{"name":"Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA"},{"name":"Corewell Health William Beaumont University Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA"},{"name":"Corewell Health William Beaumont University Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073, 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Estimating the Progression and Cost of the US Obesity Epidemic","volume":"16","author":"Wang","year":"2008","journal-title":"Obesity"},{"key":"ref_2","first-page":"e984","article-title":"Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association","volume":"143","author":"Poirier","year":"2021","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"285","DOI":"10.2147\/DMSO.S7384","article-title":"The economic impact of obesity in the United States","volume":"3","author":"Hammond","year":"2010","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.2147\/PPA.S103649","article-title":"Weight loss intervention adherence and factors promoting adherence: A meta-analysis","volume":"10","author":"Lemstra","year":"2016","journal-title":"Patient Prefer. Adherence"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2337\/ds017-0025","article-title":"Why Weight Loss Maintenance Is Difficult","volume":"30","author":"Evert","year":"2017","journal-title":"Diabetes Spectr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.clinimag.2020.11.020","article-title":"A review of commonly performed bariatric surgeries: Imaging features and its complications","volume":"72","author":"Gandhi","year":"2021","journal-title":"Clin. Imaging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jpge.2015.04.004","article-title":"Bariatric Analysis and Reporting Outcome System (BAROS): Toward the Uniform Assessment of Bariatric Surgery Outcomes","volume":"22","author":"Costa","year":"2015","journal-title":"GE Port. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"46","DOI":"10.7570\/jomes23008","article-title":"Weight Loss Prediction after Metabolic and Bariatric Surgery","volume":"32","author":"Park","year":"2023","journal-title":"J. Obes. Metab. Syndr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"8370304","DOI":"10.1155\/2018\/8370304","article-title":"Anthropometric Indicators of Adiposity Related to Body Weight and Body Shape as Cardiometabolic Risk Predictors in British Young Adults: Superiority of Waist-to-Height Ratio","volume":"2018","author":"Amirabdollahian","year":"2018","journal-title":"J. Obes."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Sohn, M.-J., Chae, W., Ko, J.-S., Cho, J.-Y., Kim, J.-E., Choi, J.-Y., Jang, H.-B., Lee, H.-J., Park, S.-I., and Moon, J.-S. (2022). Metabolomic Signatures for the Effects of Weight Loss Interventions on Severe Obesity in Children and Adolescents. Metabolites, 12.","DOI":"10.3390\/metabo12010027"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Du, Y., Li, Y.-Y., Choi, B.Y., Fernadez, R., Su, K.-J., Sharma, K., Qi, L., Yin, Z., Zhao, Q., and Shen, H. (2023). Metabolomic profiles associated with physical activity in White and African American adult men. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0289077"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Miller, W.M., Ziegler, K.M., Yilmaz, A., Saiyed, N., Ustun, I., Akyol, S., Idler, J., Sims, M.D., Maddens, M.E., and Graham, S.F. (2023). Association of Metabolomic Biomarkers with Sleeve Gastrectomy Weight Loss Outcomes. Metabolites, 13.","DOI":"10.3390\/metabo13040506"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1038\/s41588-018-0135-7","article-title":"The fecal metabolome as a functional readout of the gut microbiome","volume":"50","author":"Zierer","year":"2018","journal-title":"Nat. Genet."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Cui, M., Trimigno, A., Castro-Mej\u00eda, J.L., Reitelseder, S., B\u00fclow, J., Bechsh\u00f8ft, R.L., Nielsen, D.S., Holm, L., Engelsen, S.B., and Khakimov, B. (2021). Human Fecal Metabolome Reflects Differences in Body Mass Index, Physical Fitness, and Blood Lipoproteins in Healthy Older Adults. Metabolites, 11.","DOI":"10.3390\/metabo11110717"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1001\/jamasurg.2013.3654","article-title":"The Effectiveness and Risks of Bariatric Surgery: An Updated Systematic Review and Meta-analysis, 2003\u20132012","volume":"149","author":"Chang","year":"2014","journal-title":"JAMA Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.amjmed.2008.09.041","article-title":"Weight and type 2 diabetes after bariatric surgery: Systematic review and meta-analysis","volume":"122","author":"Buchwald","year":"2009","journal-title":"Am. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.soard.2012.06.014","article-title":"Weight loss at first postoperative visit predicts long-term outcome of Roux-en-Y gastric bypass using Duke weight loss surgery chart","volume":"8","author":"Mor","year":"2012","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s10858-011-9480-x","article-title":"Towards automatic metabolomic profiling of high-resolution one-dimensional proton NMR spectra","volume":"49","author":"Mercier","year":"2011","journal-title":"J. Biomol. NMR"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ravanbakhsh, S., Liu, P., Bjorndahl, T.C., Mandal, R., Grant, J.R., Wilson, M., Eisner, R., Sinelnikov, I., Hu, X., and Luchinat, C. (2015). Accurate, Fully-Automated NMR Spectral Profiling for Metabolomics. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0132873"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1093\/biostatistics\/kxj037","article-title":"Adjusting batch effects in microarray expression data using empirical Bayes methods","volume":"8","author":"Johnson","year":"2007","journal-title":"Biostatistics"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1093\/nar\/gkv007","article-title":"limma powers differential expression analyses for RNA-sequencing and microarray studies","volume":"43","author":"Ritchie","year":"2015","journal-title":"Nucleic Acids Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e085304","DOI":"10.1136\/bmj-2025-085304","article-title":"Weight regain after cessation of medication for weight management: Systematic review and meta-analysis","volume":"392","author":"West","year":"2026","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1001\/jamasurg.2025.3590","article-title":"Obesity Treatment With Bariatric Surgery vs GLP-1 Receptor Agonists","volume":"160","author":"Barrett","year":"2025","journal-title":"JAMA Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/jdi.13328","article-title":"Metabolic alterations in plasma after laparoscopic sleeve gastrectomy","volume":"12","author":"Yoshida","year":"2021","journal-title":"J. Diabetes Investig."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1038\/ijo.2017.124","article-title":"Metabolite profiling of obese individuals before and after a one year weight loss program","volume":"41","author":"Geidenstam","year":"2017","journal-title":"Int. J. Obes."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Palau-Rodriguez, M., Tulipani, S., Marco-Ramell, A., Mi\u00f1arro, A., J\u00e1uregui, O., Sanchez-Pla, A., Ramos-Molina, B., Tinahones, F.J., and Andres-Lacueva, C. (2018). Metabotypes of response to bariatric surgery independent of the magnitude of weight loss. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198214"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11695-020-04925-2","article-title":"Metabolomic Analysis of the Improvements in Insulin Secretion and Resistance After Sleeve Gastrectomy: Implications of the Novel Biomarkers","volume":"31","author":"Kwon","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4486","DOI":"10.1210\/jc.2017-01020","article-title":"A Metabolomic Signature of Acute Caloric Restriction","volume":"102","author":"Collet","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/dom.16053","article-title":"L-aspartate ameliorates diet-induced obesity by increasing adipocyte energy expenditure","volume":"27","author":"Guo","year":"2025","journal-title":"Diabetes Obes. Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2001154","DOI":"10.1002\/mnfr.202001154","article-title":"Changes in Circulating Metabolites During Weight Loss are Associated with Adiposity Improvement, and Body Weight and Adiposity Regain During Weight Loss Maintenance: The SATIN Study","volume":"65","author":"Papandreou","year":"2021","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1002\/jbmr.2564","article-title":"Does Diet-Induced Weight Loss Lead to Bone Loss in Overweight or Obese Adults? A Systematic Review and Meta-Analysis of Clinical Trials","volume":"30","author":"Zibellini","year":"2015","journal-title":"J. Bone Miner. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1161\/ATVBAHA.119.313154","article-title":"Sex Differences in Genomic Drivers of Adipose Distribution and Related Cardiometabolic Disorders: Opportunities for Precision Medicine","volume":"40","author":"Lumish","year":"2020","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.giec.2024.03.004","article-title":"Precision Medicine in Bariatric Procedures","volume":"34","author":"Gala","year":"2024","journal-title":"Gastrointest. Endosc. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1007\/s40279-024-02063-8","article-title":"Sex Differences in Energy Metabolism: A Female-Oriented Discussion","volume":"54","author":"Sanchez","year":"2024","journal-title":"Sports Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1017\/S0007114510004472","article-title":"Young women partition fatty acids towards ketone body production rather than VLDL-TAG synthesis, compared with young men","volume":"105","author":"Marinou","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Gorini, S., Camajani, E., Feraco, A., Armani, A., Karav, S., Filardi, T., Aulisa, G., Cava, E., Strollo, R., and Padua, E. (2025). Exploring Gender Differences in the Effects of Diet and Physical Activity on Metabolic Parameters. Nutrients, 17.","DOI":"10.3390\/nu17020354"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"105868","DOI":"10.1016\/j.ebiom.2025.105868","article-title":"Sex-stratified metabolic signatures of adiposity indices and their associations with clinical biomarkers in the UK Biobank","volume":"119","author":"Papagiannopoulos","year":"2025","journal-title":"eBioMedicine"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/s43856-022-00208-2","article-title":"Adiposity and NMR-measured lipid and metabolic biomarkers among 30,000 Mexican adults","volume":"2","author":"Herrington","year":"2022","journal-title":"Commun. Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"W\u00fcrtz, P., Wang, Q., Kangas, A.J., Richmond, R.C., Skarp, J., Tiainen, M., Tynkkynen, T., Soininen, P., Havulinna, A.S., and Kaakinen, M. (2014). Metabolic Signatures of Adiposity in Young Adults: Mendelian Randomization Analysis and Effects of Weight Change. PLoS Med., 11.","DOI":"10.1371\/journal.pmed.1001765"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Lee, L.M.-Y., Lin, Z.-Q., Zheng, L.-X., Tu, Y.-F., So, Y.-H., Zheng, X.-H., Feng, T.-J., Wang, X.-Y., Wong, W.-T., and Leung, Y.-C. (2023). Lysine Deprivation Suppresses Adipogenesis in 3T3-L1 Cells: A Transcriptome Analysis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24119402"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"9953","DOI":"10.1038\/s41467-025-64892-z","article-title":"A lysine-restricted diet ameliorates obesity via enrichment of Parabacteroides goldsteinii and 1,4-methylimidazoleacetic acid","volume":"16","author":"Zhao","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_42","first-page":"70","article-title":"Glutamate and obesity\u2014What is the link?","volume":"27","author":"Chaouche","year":"2024","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"27138","DOI":"10.1074\/jbc.M113.485094","article-title":"Uric Acid Secretion from Adipose Tissue and Its Increase in Obesity","volume":"288","author":"Tsushima","year":"2013","journal-title":"J. Biol. Chem."},{"key":"ref_44","first-page":"e58103","article-title":"Bariatric Surgery and Its Metabolic Echo Effect on Serum Uric Acid Levels","volume":"16","author":"Bashyal","year":"2024","journal-title":"Cureus"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3815","DOI":"10.1007\/s11695-018-3416-4","article-title":"The Effects of Bariatric Surgery on Renal Outcomes: A Systematic Review and Meta-analysis","volume":"28","author":"Bilha","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3628","DOI":"10.1093\/rheumatology\/keaa822","article-title":"Effects of bariatric surgery on serum uric acid in people with obesity with or without hyperuricaemia and gout: A retrospective analysis","volume":"60","author":"Lu","year":"2021","journal-title":"Rheumatology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"48","DOI":"10.5534\/wjmh.190009","article-title":"Sex Differences in Gut Microbiota","volume":"38","author":"Kim","year":"2020","journal-title":"World J. Mens. Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.clinbiochem.2008.06.010","article-title":"Specific, rapid, and sensitive enzymatic measurement of sphingomyelin, phosphatidylcholine and lysophosphatidylcholine in serum and lipid extracts","volume":"41","author":"Hidaka","year":"2008","journal-title":"Clin. Biochem."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Heimerl, S., Fischer, M., Baessler, A., Liebisch, G., Sigruener, A., Wallner, S., and Schmitz, G. (2014). Alterations of Plasma Lysophosphatidylcholine Species in Obesity and Weight Loss. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0111348"},{"key":"ref_50","first-page":"E537","article-title":"Longitudinal studies","volume":"7","author":"Caruana","year":"2015","journal-title":"J. Thorac. Dis."}],"container-title":["Metabolites"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-1989\/16\/7\/497\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:59:52Z","timestamp":1784174392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-1989\/16\/7\/497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":50,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["metabo16070497"],"URL":"https:\/\/doi.org\/10.3390\/metabo16070497","relation":{},"ISSN":["2218-1989"],"issn-type":[{"value":"2218-1989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]}}}