Can genetics help predict efficacy of bariatric surgery? An analysis of micro-ribonucleic acid profiles.

Setting There is significant variability in weight loss after bariatric surgery. We hypothesize that part of this variability may be pre-determined by genetic differences associated with metabolic homeostasis. MicroRNA (miRNA) are short pieces of ribonucleic acid (RNA) that regulate gene expression and are readily detectable in serum. They are implicated in numerous metabolic processes, including weight homeostasis. In this pilot study we briefly review the role of miRNA, and assess the feasibility of using them in the clinical setting of obesity treatment. Objectives Evaluate the feasibility of using miRNA to predict weight loss after bariatric surgery. Methods Serum was collected from patients at the initial bariatric surgery consultation. Weight loss data was collected 6-12 months postoperatively. Individuals experiencing the least and the greatest amount of percentage of excess weight lost (%EWL) at 6 months were analyzed to assess for genetic differences in miRNA expression. Results The median %EWL was 51% (range 34-63%) for those who lost the least and 87% (range 82-111%) for those who lost the most weight. Groups were similar in age, gender, diabetic status, and type of surgery. In total, of the 119 miRNA that were detected in the serum of the subjects, six demonstrated potential for discriminating between the high and low weight loss groups. These miRNA have previously been implicated in regulation of fatty acid biosynthesis, adipocyte proliferation, type II diabetes and obesity. Conclusions In this pilot study, we demonstrated the feasibility of identifying genetic differences between high and low weight loss groups by identifying distinct serum miRNA. In the near future, these biomarkers could facilitate informed decisions about surgery. Additionally, these miRNA could open new genetic pathways that describe the pathophysiology of obesity, and provide targets for future treatment.