The purpose of this research study is to determine how gastric bypass surgery effects metabolism in obesity and Type 2 Diabetes. One mechanism that has been investigated in animal models is change to the biology of the small intestine (Roux limb) and how glucose and other fuels are metabolized (or how the body digests and uses sugar and other fuels). This study will evaluate the role of the intestine in the beneficial metabolic effects of gastric bypass surgery. It specifically will examine whether the intestine increases its metabolism and its activity, and whether this results in an increase in fuel utilization. Thirty two (32) subjects will be recruited (18 with and 14 without Type 2 Diabetes). At the time of gastric bypass surgery, a small piece of intestine that is usually discarded will be collected. At three time points over the first year after surgery, intestinal samples will be obtained by endoscopy or insertion of a lighted flexible tube through the mouth. Blood samples will be taken at all time points, as well. All samples will undergo comprehensive metabolic analyses. Comparisons will be made between the two groups to understand the metabolic changes over time and if there are differences between the two groups.
Age range
18 Years
Sex
ALL
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Description of intestinal morphology.
Timeframe: Baseline, at time of operation
Description of intestinal morphology.
Timeframe: 1 month after surgery.
Description of intestinal morphology.
Timeframe: 6 months after surgery.
Description of intestinal morphology.
Timeframe: 12 months after surgery.
Characterization of gene and protein expression of markers of cellular proliferation, cytoskeletal remodeling, and cellular machinery of glucose and cholesterol metabolic pathways.
Timeframe: Baseline, at time of operation.
Characterization of gene and protein expression of markers of cellular proliferation, cytoskeletal remodeling, and cellular machinery of glucose and cholesterol metabolic pathways.
Timeframe: 1 month after surgery.
Characterization of gene and protein expression of markers of cellular proliferation, cytoskeletal remodeling, and cellular machinery of glucose and cholesterol metabolic pathways.
Timeframe: 6 months after surgery.
Characterization of gene and protein expression of markers of cellular proliferation, cytoskeletal remodeling, and cellular machinery of glucose and cholesterol metabolic pathways.
Timeframe: 12 months after surgery.
Description of metabolite profile of the intestine and serum/plasma.
Timeframe: Baseline, at time of operation.
Description of metabolite profile of the intestine and serum/plasma.
Timeframe: 1 month after surgery.
Description of metabolite profile of the intestine and serum/plasma.
Timeframe: 6 months after surgery.
Description of metabolite profile of the intestine and serum/plasma.
Timeframe: 12 months after surgery.
Change from baseline (time of operation) in morphological signatures.
Timeframe: Baseline (0 months) and 1 month, 6 months and 12 months post-surgery.
Change from baseline (time of operation) in gene and protein expression for markers of cellular proliferation, cytoskeletal remodeling, and cellular machinery of glucose and cholesterol metabolic pathways.
Timeframe: Baseline (0 months) and 1 month, 6 months and 12 months post-surgery.
Change from baseline (time of operation) in metabolite profile.
Timeframe: Baseline (0 months) and 1 month, 6 months and 12 months post-surgery.