Changes in fasting bile acid profiles after Roux-en-Y gastric bypass and sleeve gastrectomy

Zhang, Chunlan; Zhang, Jingjing; Zhang, Zhou

doi:10.1097/md.0000000000023939

Cited by 11 publications

(7 citation statements)

References 39 publications

(25 reference statements)

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“…Whether improved glycemic control after RYGB is a consequence of slightly better weight control seen in several major studies, or a direct effect of altered gut physiology, is currently an important research topic. A recent meta-analysis showed elevated levels of circulating bile acids after RYGB, but not after SG, possibly due to the anatomical construction of a biliopancreatic limb in RYGB [ 44 ]. Circulating bile acid concentrations were found to be inversely related to HOMA-IR [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

et al. 2022

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Background/objectives There is limited long-term data comparing the outcomes of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) for severe obesity, both with respect to body weight, quality of life (QOL) and comorbidities. We aimed to determine 7-year trajectories of body mass index (BMI), QOL, obesity-related comorbidities, biomarkers of glucose and lipid metabolism, and early major complications after SG and RYGB. Subjects/methods Patients scheduled for bariatric surgery at two Norwegian hospitals, preferentially performing either SG or RYGB, were included consecutively from September 2011 to February 2015. Data was collected prospectively before and up to 7 years after surgery. Obesity-specific, generic and overall QOL were measured by the Impact of Weight on Quality of Life-Lite, Short-Form 36 and Cantril’s ladder, respectively. Comorbidities were assessed by clinical examination, registration of medication and analysis of glucose and lipid biomarkers. Outcomes were examined with linear mixed effect models and relative risk estimates. Results Of 580 included patients, 543 (75% women, mean age 42.3 years, mean baseline BMI 43.0 kg/m2) were operated (376 SG and 167 RYGB). With 84.2% of participants evaluable after 5–7 years, model-based percent total weight-loss (%TWL) at 7 years was 23.4 after SG versus 27.3 after RYGB (difference 3.9%, p = 0.001). All levels of QOL improved similarly after the two surgical procedures but remained below reference data from the general population at all timepoints. Remission rates for type 2 diabetes, dyslipidemia, obstructive sleep-apnea and gastroesophageal reflux disease (GERD) as well as the rate of de novo GERD significantly favored RYGB. SG had fewer major early complications, but more minor and major late complications combined over follow-up. Conclusion In routine health care, both SG and RYGB are safe procedures with significant long-term weight-loss, improvement of QOL and amelioration of comorbidities. Long-term weight-loss and remission rates of main obesity-related comorbidities were higher after RYGB.

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Section: Discussionmentioning

confidence: 99%

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

et al. 2022

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“…The liver plays a central role in determining this condition [35] . Indeed, subjects with severe obesity show an altered hepatic fatty acids trafficking: intra-hepatic fatty acids are shifted towards very-low LDL (VLDL) and triglycerides production rather than oxidative pathways [36] . These mechanisms may explain the different lipid profiles detected in subjects with severe obesity.…”

Section: Discussionmentioning

confidence: 99%

Effects of bariatric and metabolic surgical procedures on dyslipidemia: a retrospective, observational analysis

Greco¹,

Passerini²,

Coluccia³

et al. 2022

Metab Target Organ Damage

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Aim: Obesity and co-existing metabolic comorbidities are associated with increased cardiovascular (CV) morbidity and mortality risks, generally clustered to risk factors such as dyslipidemia. The aim of this study was to evaluate the lipid profile changes in subjects with severe obesity undergoing different procedures of bariatric and metabolic surgery (BMS), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) in a real-world, clinical setting. Methods: A single-center, retrospective, observational clinical study was performed enrolling patients undergoing BMS. The primary outcome was the change in total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, and triglycerides. Results: In total, 123 patients were enrolled (males 25.2% and females 74.8%) with a mean age of 48.2 ± 7.9 years and a mean BMI of 47.0 ± 9.1 kg/m2. All patients were evaluated until 16.9 ± 8.1 months after surgery. Total and HDL cholesterol did not change after surgery, while a significant reduction in triglyceride levels was recorded. Moreover, a rapid decline of both LDL and non-HDL cholesterol among follow-up visits was observed. In particular, significant inverse correlations were found between total cholesterol, LDL cholesterol, non-HDL cholesterol, and triglycerides and the number of months elapsed after bariatric surgery. Similarly, a direct correlation was found considering HDL cholesterol. Moreover, total cholesterol, LDL cholesterol, non-HDL cholesterol, and triglycerides significantly changed among visits after RYGB, while no changes were observed in the SG group. Finally, considering lipid-lowering therapies, the improvement in lipid asset was detected only in non-treated patients. Conclusion: This study corroborates the knowledge of the improvement in lipid profile with BMS in clinical practice. Together with sustained weight loss, the BMS approach efficiently corrects dyslipidemia, contributing to decreasing the CV risk.

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“…On the contrary, a meta-analysis published by Zhang et al. revealed that after RYGB, the ratio of 12-α-OH: non-12-α-OH bile acids increased instead of decreased in human subjects ( 36 ).…”

Section: Bile Acids and Their Receptorsmentioning

confidence: 99%

“…The findings in VSG are a bit more varied. A study done in rodents reported that total serum bile acids increased after VSG ( 35 ), but a meta-analysis showed that total serum bile acids did not increase in human subjects after VSG ( 36 ). In another study by Chen et al , the authors reported that after human patients received RYGB and VSG, total bile acids in the blood was increased at both three days and three months after surgery ( 37 ).…”

Section: Bile Acids and Their Receptorsmentioning

confidence: 99%

Bile acids, gut microbiota and metabolic surgery

Wang

Jin

et al. 2022

Front. Endocrinol.

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Metabolic surgery, or bariatric surgery, is currently the most effective approach for treating obesity and its complications. Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) are the top two types of commonly performed metabolic surgery now. The precise mechanisms of how the surgeries work are still unclear, therefore much research has been conducted in this area. Gut hormones such as GLP-1 and PYY have been studied extensively in the context of metabolic surgery because they both participate in satiety and glucose homeostasis. Bile acids, whose functions cover intestinal lipid absorption and various aspects of metabolic regulation via the action of FXR, TGR5, and other bile acid receptors, have also been actively investigated as potential mediators of metabolic surgery. Additionally, gut microbiota and their metabolites have also been studied because they can affect metabolic health. The current review summarizes and compares the recent scientific progress made on identifying the mechanisms of RYGB and VSG. One of the long-term goals of metabolic/bariatric surgery research is to develop new pharmacotherapeutic options for the treatment of obesity and diabetes. Because obesity is a growing health concern worldwide, there is a dire need in developing novel non-invasive treatment options.

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Changes in fasting bile acid profiles after Roux-en-Y gastric bypass and sleeve gastrectomy

Cited by 11 publications

References 39 publications

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

Effects of bariatric and metabolic surgical procedures on dyslipidemia: a retrospective, observational analysis

Bile acids, gut microbiota and metabolic surgery

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