Key result
Preoperative metabolomics improves post-bariatric blood pressure reduction prediction, boosting AUC to ~0.76 vs clinical factors alone.
Why the study?
It was unknown whether preoperative metabolomic and proteomic profiles predict long-term elevated blood pressure changes better than known risk factors in adolescents undergoing bariatric surgery.
Does integrating preoperative metabolomic and proteomic profiles with known clinical risk factors improve the prediction of long-term elevated blood pressure reductions in adolescents following bariatric surgery?
Cohort (n=108)
Yes
Does integrating preoperative metabolomic and proteomic profiles with known clinical risk factors improve the prediction of long-term elevated blood pressure reductions in adolescents following bariatric surgery?
Absolute Event Rate: 0.76% vs 0.52%
p-value: p=<0.01
Integrating preoperative plasma metabolomics and proteomics with known clinical risk factors significantly improves the prediction of long-term blood pressure reduction in adolescents following bariatric surgery.
Hypothesis-generating for metabolomic-enhanced BP prediction after adolescent bariatric surgery; prospective validation needed before clinical adoption.
BACKGROUND: Emerging omics approaches, including metabolomics and proteomics, can be integrated into obesity treatment for better blood pressure management. We tested whether preoperative metabolomic and proteomic profiles predict long-term elevated blood pressure (EBP) changes better than known risk factors in adolescents undergoing bariatric surgery. METHODS: We included 108 participants from the Teen-LABS (Teen-Longitudinal Assessment of Bariatric Surgery). Plasma untargeted metabolomics (via liquid chromatography with high-resolution mass spectrometry) and Olink proteomics were assessed pre surgery. An elastic net model with stability selection was used to identify features predictive of EBP reductions 5 years post surgery. Models including identified metabolites, proteins, and known risk factors (age, sex, race, clinical sites, parents' education level, body mass index, systolic blood pressure, and diastolic blood pressure at baseline) were compared with known-risk-factors-only models. For biological relevance, the consistency of association directions was examined in a multiethnic non-interventional adolescent cohort (n=79). RESULTS: <0.01). Higher levels of 4 metabolites (uric acid, taurocholic acid, nonadecanoic acid, and cystine) were consistently associated with reduced likelihood of EBP improvement or blood pressure improvement across cohorts. SERPINA11 (serine protease inhibitor, clade A, member 11), ICAM5 (intercellular adhesion molecule 5), and TINAGL1 (tubulointerstitial nephritis antigen-like 1) demonstrated consistent associations in both cohorts. CONCLUSIONS: This is the first study identifying potential preoperative biomarkers for EBP reductions in adolescents following bariatric surgery. Integrating metabolomics and proteomics with known risk factors substantially improved predictive models compared with known-risk-factors-only models. Larger and more diverse cohorts are needed to confirm these findings and whether identified features are associated with other blood pressure treatments.
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Pan et al. (2025) conducted a cohort in Elevated blood pressure and severe obesity (n=108). Preoperative plasma metabolomic and proteomic profiles integrated with clinical risk factors vs. Known clinical risk factors-only models was evaluated on Prediction of elevated blood pressure reductions 5 years post-surgery (AUC of metabolite-based models) (p=<0.01). Integrating preoperative plasma metabolomic signatures with known clinical risk factors significantly improved the prediction of elevated blood pressure reduction 5 years after bariatric surgery compared to risk factors alone (mean AUC 0.76 vs 0.52).
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