Oea Signaling Pathways and the Metabolic Benefits of Vertical Sleeve Gastrectomy

Ann Surg. 2020 Mar;271(3):509-518. doi: 10.1097/SLA.0000000000003093.


Objective: The aim of this study was to determine whether downstream [peroxisome proliferator-activated-receptor alpha (PPARα) and the G-protein coupled receptor, GPR119] and upstream (a fatty acid translocase, CD36) signaling targets of N-oleoylethanolamide (OEA) were necessary for weight loss, metabolic improvements, and diet preference following vertical sleeve gastrectomy (VSG).

Summary background data: OEA is an anorectic N-acylethanolamine produced from dietary fats within the intestinal lumen that can modulate lipid metabolism, insulin secretion, and energy expenditure by activating targets such as PPARα and GPR119.

Methods: Diet-induced obese mice, including wild-type or whole body knockout (KO) of PPARα, GPR119, and CD36, were stratified to either VSG or sham surgery before body weight, body composition, diet preference, and glucose and lipid metabolic endpoints were assessed.

Results: We found increased duodenal production of OEA and expression of both GPR119 and CD36 were upregulated in wild-type mice after VSG. However, weight loss and glucose tolerance were improved in response to VSG in PPARαKO, GPR119KO, and CD36KO mice. In fact, VSG corrected hepatic triglyceride dysregulation in CD36KO mice, and circulating triglyceride and cholesterol levels in PPARαKO mice. Lastly, we found PPARα-mediated signaling contributes to macronutrient preference independent of VSG, while removal of CD36 signaling blunts the VSG-induced shift toward carbohydrate preference.

Conclusions: In the search for more effective and less invasive therapies to help reverse the global acceleration of obesity and obesity-related disease OEA is a promising candidate; however, our data indicate that it is not an underlying mechanism of the effectiveness of VSG.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Disease Models, Animal
  • Endocannabinoids / metabolism*
  • Ethanolamines / metabolism*
  • Gastrectomy / methods*
  • Gene Expression
  • Glucose Tolerance Test
  • Lipids / blood
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Obesity / metabolism*
  • Obesity / surgery*
  • Oleic Acids / metabolism*
  • PPAR alpha / metabolism
  • Rats
  • Receptors, G-Protein-Coupled / metabolism
  • Scavenger Receptors, Class B / metabolism
  • Signal Transduction*
  • Up-Regulation


  • Endocannabinoids
  • Ethanolamines
  • Gpr119 protein, mouse
  • Lipids
  • Oleic Acids
  • PPAR alpha
  • Receptors, G-Protein-Coupled
  • Scarb1 protein, mouse
  • Scavenger Receptors, Class B
  • N-oleoylethanolamine