FRI071 Changes In Branched-chain Amino Acids One-year After Sleeve Gastrectomy In Youth With Obesity And Its Association With Changes In Insulin Resistance

Abstract Disclosure: I. Becetti: None. M. Lauze: None. H. Lee: None. M. Bredella: None. M. Misra: None. V. Singhal: None. Introduction: Branched-chain amino acids (BCAAs), isoleucine, leucine and valine, have been linked to obesity, insulin resistance (IR) and risk for type 2 diabetes. Adults with obesity have a reduction in BCAA levels following metabolic and bariatric surgery (MBS), which may contribute to the modulation of metabolic advantages of MBS. We examine for the first time this relationship in youth with moderate-to-severe obesity who underwent sleeve gastrectomy (SG). Objective: To examine changes in dietary intake and serum BCAAs in youth with obesity one-year after SG, and their associations with changes in markers of IR. Methods: 53 youth 13-25 years old with severe obesity (41 females) were followed for a year; 25 had SG and 28 were non-surgical controls (NS). Subjects had fasting glucose and insulin levels and a 24-hour food recall. We assessed baseline and 12-month change within (Wilcoxon signed-rank test) and between (Student’s t-test/Wilcoxon Rank Sum test) groups, and associations between BCAAs and markers of IR (Spearman’s correlation). Results: SG and NS groups were similar for age, sex and race. SG had higher median body mass index (BMI) vs. NS at baseline [45.3 (42.1, 53.7) vs. 41.9 (38.4, 47.1) kg/m2; p=0.02]. At baseline, SG and NS did not differ for intake or serum levels of isoleucine, leucine, valine or total BCAAs. SG and NS groups also did not differ at baseline for glycated hemoglobin (HbA1C) or Homeostatic Model Assessment for Insulin Resistance (HOMA-IR, marker of IR). Over a year, SG vs. NS had greater reductions in BMI, serum isoleucine, leucine, valine and BCAAs (p≤0.02), and SG had significant within group reductions in intake of isoleucine, leucine, valine and BCAAs (p≤0.048). Further, SG vs. NS groups had greater reductions in HbA1c and HOMA-IR (p≤0.007). Serum BCAA levels were not associated with their dietary intake. Baseline HOMA-IR was positively associated with baseline serum levels of leucine (ρ=0.56, p=0.01). Over one year, decreases in HOMA-IR and HbA1c were positively associated with decreases in serum valine (ρ=0.60 and ρ=0.63, p=0.01 and p=0.007, respectively). Associations between changes in HOMA-IR and serum valine held after controlling for BMI (baseline and change) and dietary intake of valine. Conclusion: We demonstrate decreases in BCAA intake and serum levels one-year post-SG in youth with obesity. Associations between BCAAs and IR markers, even after controlling for BMI, suggest a potential role of BCAA in regulating metabolic health. Reducing serum levels of BCAAs may reduce IR. Presentation: Friday, June 16, 2023