Plasma Omics Predict Long-Term Blood Pressure Reduction After Adolescent Bariatric Surgery

Article Impact Level: HIGH
Data Quality: STRONG
Summary of Hypertension https://doi.org/10.1161/HYPERTENSIONAHA.125.25261  
Dr. Shudi Pan  et al.

Points

This study is the first to identify preoperative biomarkers in 108 adolescents undergoing bariatric surgery that predict long-term reductions in elevated blood pressure (EBP).
Models integrating metabolomic and proteomic profiles with known risk factors significantly outperformed models using known risk factors only in predicting EBP reductions 5 years post-surgery (P < 0.01).
Higher plasma levels of four metabolites—uric acid, taurocholic acid, nonadecanoic acid, and cystine—were consistently associated with a reduced likelihood of EBP improvement across cohorts.
Three proteins, including SERPINA11, ICAM5, and TINAGL1, also showed consistent associations in the 108 Teen-LABS participants and an independent 79-person noninterventional cohort.
Integrating these molecular signatures with standard clinical data offers a promising pathway for personalized obesity treatment and improved preoperative counseling for blood pressure management.

Summary

This study utilized emerging omics approaches to test whether preoperative metabolomic and proteomic profiles could predict long-term reductions in elevated blood pressure (EBP) more effectively than established clinical and demographic risk factors in adolescents undergoing bariatric surgery. The investigation included 108 participants from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort. Preoperative assessment involved plasma untargeted metabolomics via liquid chromatography with high-resolution mass spectrometry and Olink proteomics. An elastic net model incorporating stability selection was employed to identify features predictive of EBP reductions 5 years post-surgery, and its predictive capability was compared against models relying solely on known risk factors (sex, race, clinical site, parental education, baseline BMI, systolic BP, and diastolic BP).

The results demonstrated that both metabolite-based and protein-based models, when integrated with known risk factors, significantly outperformed risk factor-only models in predicting EBP reductions (P < 0.01). For biological relevance validation, the consistency of association directions was examined in an additional multiethnic noninterventional adolescent cohort (n = 79). This cross-cohort analysis identified four metabolites—uric acid, taurocholic acid, nonadecanoic acid, and cystine—whose higher levels were consistently associated with a reduced likelihood of EBP or overall blood pressure improvement. Furthermore, three proteins—SERPINA11 (serine protease inhibitor, clade A, member 11), ICAM5 (intercellular adhesion molecule 5), and TINAGL1 (tubulointerstitial nephritis antigen-like 1)—also demonstrated consistent associations in both cohorts. These findings mark the first identification of potential preoperative biomarkers for EBP reductions in this population. The substantial improvement in predictive models achieved by integrating omics data supports their critical utility in personalized obesity treatment, though confirmation in larger and more diverse cohorts is recommended.

Link to the article: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.125.25261

References

Pan, S., Li, Z., Lewinger, J. P., Goodrich, J. A., Wang, H., Rock, S., Chen, C., Jenkins, T. M., Sisley, S., Daniels, S., Walker, D. I., Aung, M. T., Garcia, E., McConnell, R., Eckel, S. P., La Merrill, M. A., Alderete, T. L., Chen, Z., Gilliland, F. D., … Chatzi, L. (2025). Plasma metabolomic and proteomic signatures of blood pressure management after bariatric surgery among adolescents. Hypertension, HYPERTENSIONAHA.125.25261. https://doi.org/10.1161/HYPERTENSIONAHA.125.25261