Bile acid, glucose, lipid profile, and liver enzyme changes in prediabetic patients 1 year after sleeve gastrectomy

Abstract

Background: Few articles have studied individuals with prediabetes after sleeve gastrectomy. Bile acid and lipid levels remain inconsistent in postbariatric patients. The purpose of this study was to explore bile acid, glucose, lipid, and liver enzyme changes in patients with different diabetes statuses who underwent sleeve gastrectomy. The impact of bariatric surgery and its potential benefits for prediabetic patients was also discussed.Methods: A total of 202 overweight and obese patients who underwent bariatric surgery in our hospital between January 2016 and October 2018 were retrospectively reviewed. Patients were divided into prediabetes (n=32), nondiabetes (n=144), and diabetes (n=26) groups and analysed. Glucose and lipid data were collected from medical records at baseline and at each follow-up visit.Result: Significant improvements in body weight, glucose and lipid levels, and liver enzymes (P≤0.05) in prediabetic patients were found throughout the first year postoperatively. Improvement in glycaemic control was first seen one month postoperatively, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, which was associated with ALT improvement in prediabetic patients 1-year post-surgery. There were no significant differences in HbA1c, glucose, or triglycerides (TGs) between prediabetic and T2DM patients or between prediabetic and nondiabetic patients at 12 months post-surgery.Conclusion: LSG is highly effective at interfering with glucose and lipid levels as well as total bile acid levels in prediabetic patients in the first year postoperatively. Thus, LSG is indeed an alternative for overweight and obese prediabetic patients.

Research progress on the relationship between bile acid metabolism and type 2 diabetes mellitus

“…Bariatric metabolic surgery can also achieve the effect of treating T2DM by changing the composition of BAs and improving insulin resistance [68][69][70][71]. However, there is controversy regarding changes in bile acid concentration after metabolic surgery.…”