Bile Acids Increase Independently From Hypocaloric Restriction After Bariatric Surgery

Jahansouz, Cyrus; Xu, Hong‐Liang; Hertzel, Ann V.; Serrot, Federico J.; Kvalheim, Nicholas; Cole, Abigail J.; Abraham, Anasooya; Luthra, Girish; Ewing, Kristin; Leslie, Daniel B.; Bernlohr, David A.; Ikramuddin, Sayeed

doi:10.1097/sla.0000000000001552

Cited by 69 publications

(55 citation statements)

References 26 publications

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“…These reports thus indicate that serum bile acid levels were increased by bariatric surgery through normalizing of the gut microbiota profile and possibly associated with improved glucose and lipid metabolism, including insulin resistance after metabolic surgery. In addition, vertical sleeve gastrectomy, but not a hypocaloric diet, increased circulating serum bile acid level in obese patients with diabetes [38]. These findings may support the notion that LSG increased preheparin LPL level independent of the decrease in BMI.…”

Section: Discussionsupporting

confidence: 77%

Laparoscopic Sleeve Gastrectomy Significantly Increases Serum Lipoprotein Lipase Level in Obese Patients

et al. 2019

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Objectives: Obesity is one of the causes of metabolic disorders. Laparoscopic sleeve gastrectomy (LSG) confers beneficial effects not only on body weight (BW) but also on metabolic disorders. The lipoprotein lipase (LPL) level in preheparin serum is associated with visceral adipose tissue and reflects insulin resistance. However, the change in serum preheparin LPL levels after LSG remains unclear. This study aimed to examine the effect of LSG on preheparin LPL level in obese patients compared with nonsurgical treatment. Methods: We retrospectively reviewed a total of 100 obese patients who were treated for obesity and had preheparin LPL levels measured before and 12 months after LSG or after 12 months of nonsurgical treatment. Fifty-six patients received LSG (LSG group), and 44 patients had no surgical treatment (nonsurgical group). We compared clinical parameters such as body mass index (BMI), hemoglobin A_1c (HbA_1c), and preheparin LPL level before and 12 months after treatment. Results: BMI and HbA_1c decreased significantly in both groups, but decreases in both parameters were greater in the LSG group than in the nonsurgical group. Estimated glomerular filtration was significantly improved only in the LSG group. Preheparin LPL level increased significantly only in the LSG group (from 45.8 ± 21.6 to 75.0 ± 34.9 ng/mL, p < 0.001). Multiple regression identified LSG and decreased BMI as independent predictors of preheparin LPL level increase. Conclusions: These results suggest that LSG independently increases preheparin LPL level beyond BW reduction in obese patients.

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Section: Discussionsupporting

confidence: 77%

Laparoscopic Sleeve Gastrectomy Significantly Increases Serum Lipoprotein Lipase Level in Obese Patients

et al. 2019

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“…In large part, human studies have confirmed that fasting or postprandial total bile acid concentrations are increased following RYGB (Ahmad et al, 2013; Albaugh et al, 2015; De Giorgi et al, 2015; Ferrannini et al, 2015; Gerhard et al, 2013; Jahansouz et al, 2016; Jørgensen et al, 2015; Nakatani et al, 2009; Pournaras et al, 2012; Simonen et al, 2012; Steinert et al, 2013; Werling et al, 2013b) and BPD (Ferrannini et al, 2015; Nakatani et al, 2009). The effects of VSG on bile acid levels is mixed with some showing increased plasma concentrations (Jahansouz et al, 2016; Khan et al, 2016; Steinert et al, 2013), but others detecting no change (Belgaumkar et al, 2016; Escalona et al, 2016; Nakatani et al, 2009). As expected, studies examining adjustable gastric banding, known to be an exclusively restrictive procedure, show no changes in circulating bile acids (Kohli et al, 2013a; Pournaras et al, 2012).…”

Section: Bile Acids and Obesitymentioning

confidence: 98%

“…While caloric restriction does not appear to affect bile acid pool size or composition in man (Duane et al, 1976; Jahansouz et al, 2016; van Nierop et al, 2016), the few studies that have examined the effect of altering dietary fat source and fat composition, commonly occurring in the postoperative period, have yielded inconsistent effects (Andersén and Hellström, 1980; Lindstedt et al, 1965). Diet is known to induce changes in bile acid species and total bile acid pool (Bisschop et al, 2004; M.…”

Section: Bile Acids and Obesitymentioning

confidence: 99%

Bile acids and bariatric surgery

Albaugh

Banan

Ajouz

et al. 2017

Molecular Aspects of Medicine

111

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Bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), are the most effective and durable treatments for morbid obesity and potentially a viable treatment for type 2 diabetes (T2D). The resolution rate of T2D following these procedures is between 40-80% and far surpasses that achieved by medical management alone. The molecular basis for this improvement is not entirely understood, but has been attributed in part to the altered enterohepatic circulation of bile acids. In this review we highlight how bile acids potentially contribute to improved lipid and glucose homeostasis, insulin sensitivity and energy expenditure after these procedures. The impact of altered bile acid levels in enterohepatic circulation is also associated with changes in gut microflora, which may further contribute to some of these beneficial effects. We highlight the beneficial effects of experimental surgical procedures in rodents that alter bile secretory flow without gastric restriction or altering nutrient flow. This information suggests a role for bile acids beyond dietary fat emulsification in altering whole body glucose and lipid metabolism strongly, and also suggests emerging roles for the activation of the bile acid receptors farnesoid x receptor (FXR) and G-protein coupled bile acid receptor (TGR5) in these improvements. The limitations of rodent studies and the current state of our understanding is reviewed and the potential effects of bile acids mediating the short-and long-term metabolic improvements after bariatric surgery is critically examined.

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“…On the other hand, bile acid concentrations have been found to be increased in obese patients with type 2 diabetes [31] . Bariatric surgery was found to increase bile acids, but a hypocaloric diet, which induced similar weight loss, was associated with a reduction in the level of uncongugated bile acids [32] , suggesting that bile acid changes are not the main reason for improvement in glucose tolerance following gastric bypass operations. FXR activation of L cells in the ileum by the bile acids may be one mechanism involved in the improvement of diabetes [33] .…”

Section: Effect Of Bile Acids On Lipid and Glucose Metabolismmentioning

confidence: 99%

Obesity diabetes and the role of bile acids in metabolism

Tomkin

Owens

2016

Journal of Translational Internal Medicine

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Bile acids have many activities over and above their primary function in aiding absorption of fat and fat soluble vitamins. Bile acids are synthesized from cholesterol, and thus are involved in cholesterol homeostasis. Bile acids stimulate glucagon-like peptide 1 (GLP1) production in the distal small bowel and colon, stimulating insulin secretion, and therefore, are involved in carbohydrate and fat metabolism. Bile acids through their insulin sensitising effect play a part in insulin resistance and type 2 diabetes. Bile acid metabolism is altered in obesity and diabetes. Both dietary restriction and weight loss due to bariatric surgery, alter the lipid carbohydrate and bile acid metabolism. Recent research suggests that the forkhead transcription factor FOXO is a central regulator of bile, lipid, and carbohydrate metabolism, but conflicting studies mean that our understanding of the complexity is not yet complete.

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Bile Acids Increase Independently From Hypocaloric Restriction After Bariatric Surgery

Abstract: The levels of serum BA increase after bariatric surgery independently from caloric restriction, whereas the level of WAT TGR5 protein is unaffected.

Cited by 69 publications

References 26 publications

Laparoscopic Sleeve Gastrectomy Significantly Increases Serum Lipoprotein Lipase Level in Obese Patients

Laparoscopic Sleeve Gastrectomy Significantly Increases Serum Lipoprotein Lipase Level in Obese Patients

Bile acids and bariatric surgery

Obesity diabetes and the role of bile acids in metabolism

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