Biliopancreatic limb plays an important role in metabolic improvement after duodenal–jejunal bypass in a rat model of diabetes

Miyachi, Tomohiro; Nagao, Munenori; Shibata, Chikashi; Kitahara, Yoshiro; Tanaka, Naoki; Watanabe, Kazuhiro; Tsuchiya, T.; Motoi, Fuyuhiko; Naitoh, Takeshi; Unno, Michiaki

doi:10.1016/j.surg.2015.11.027

Cited by 52 publications

(17 citation statements)

References 46 publications

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“…Interestingly, in a model of duodenal-jejunal bypass with short and long biliopancreatic limbs, increased BA concentrations were observed in rats with long biliopancreatic limb, together with suppression of weight gain and improved glucose metabolism [33]. This experimental study supports that a long biliopancreatic limb may be important for the metabolic improvements after bariatric surgery and suggests that BAs play a role, but the causal relationship between BAs and the metabolic improvements is still uncertain.…”

Section: Discussionsupporting

confidence: 55%

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Risstad

Kristinsson

Fagerland

et al. 2017

Surgery for Obesity and Related Diseases

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(2017). Bile acid profiles over 5 years following gastric bypass and duodenal switch -Results from a randomized clinical trial. Surgery for obesity and related diseases. https://doi.org/10.1016/j.soard.2017.05.024Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionsupporting

confidence: 55%

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Risstad

Kristinsson

Fagerland

et al. 2017

Surgery for Obesity and Related Diseases

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“…A causal relationship between cardiometabolic diseases and gastrointestinal microbiota has been inferred through associations between reduced disease risk and increased bacteria diversity and gene richness [30,31] and the identification of bacteria associated with surgically-induced remission of diabetes in obese patients [32] and in preclinical models [33][34][35][36]. The most abundant rDNA motif enriched in gastrectomised GK rats aligned to the draft genome assembly of P. copri.…”

Section: Discussionmentioning

confidence: 99%

Dominant gut Prevotella copri in gastrectomised non-obese diabetic Goto–Kakizaki rats improves glucose homeostasis through enhanced FXR signalling

et al. 2020

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Aims/hypothesis Drug and surgical-based therapies in type 2 diabetes are associated with altered gut microbiota architecture. Here we investigated the role of the gut microbiome in improved glucose homeostasis following bariatric surgery. Methods We carried out gut microbiome analyses in gastrectomised (by vertical sleeve gastrectomy [VSG]) rats of the Goto-Kakizaki (GK) non-obese model of spontaneously occurring type 2 diabetes, followed by physiological studies in the GK rat. Results VSG in the GK rat led to permanent improvement of glucose tolerance associated with minor changes in the gut microbiome, mostly characterised by significant enrichment of caecal Prevotella copri. Gut microbiota enrichment with P. copri in GK rats through permissive antibiotic treatment, inoculation of gut microbiota isolated from gastrectomised GK rats, and direct inoculation of P. copri, resulted in significant improvement of glucose tolerance, independent of changes in body weight. Plasma bile acids were increased in GK rats following inoculation with P. copri and P. copri-enriched microbiota from VSG-treated rats; the inoculated GK rats then showed increased liver glycogen and upregulated expression of Fxr (also known as Nr1h4), Srebf1c, Chrebp (also known as Mlxipl) and Il10 and downregulated expression of Cyp7a1. Conclusions Our data underline the impact of intestinal P. copri on improved glucose homeostasis through enhanced bile acid metabolism and farnesoid X receptor (FXR) signalling, which may represent a promising opportunity for novel type 2 diabetes therapeutics.

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“…Unfortunately, Risstad et al did not analyze the link between serum concentration of BAs and biliary loop length [26]. The importance of the latter parameter as a determinant of serum BA level after bariatric surgery was also demonstrated in an animal study in which an increase in bile acid concentration and improvement of glucose metabolism were observed in rats with longer biliopancreatic limb, but not in those with the shorter limb [27]. Both our hereby presented findings and the results of previous studies support the conclusion that the length of concentrated bile passage created during a bariatric surgery influences the serum level of BAs in morbidly obese patients.…”

Section: Discussionmentioning

confidence: 99%

Evidence That the Length of Bile Loop Determines Serum Bile Acid Concentration and Glycemic Control After Bariatric Surgery

et al. 2018

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Background Bariatric surgery contributes to the improvement in glucose metabolism that may be related to a postoperative increase in serum bile acids (BAs). Three commonly used types of bariatric procedures, laparoscopic sleeve gastrectomy (LSG) (without creation of a bile loop), Roux-en-Y gastric bypass (RYGB), and omega-loop gastric bypass (OLGB) (with creation of shorter 100-150 cm and longer 200-280 cm bile loops, respectively), differ in their effects on glycemic control. The aim of the study was to compare the effects of various bariatric procedures on serum BA concentration and glucose homeostasis. Methods Serum BAs in 26 obese patients were determined by liquid chromatography-mass spectrometry prior to bariatric surgery, as well as 4 days and 3 months thereafter. Results Four days after the surgery, serum concentrations of BAs in LSG and OLGB groups were similar as prior to the procedure, and a slight decrease in serum BAs was observed in the RYGB group. Serum BA level in the LSG group remained unchanged also at 3 months after the surgery, whereas a significant 0.5-and 3-fold increase in this parameter was noted in the RYGB and OLGB groups, respectively. Serum concentration of BAs correlated positively with the length of the bile loop (R = 0.47, p < 0.05). Conclusion The evident improvement of glycemic control observed 3 months after OLGB might be associated with a postoperative increase in serum BAs, resulting from their better absorption from the longer bile loop. However, the changes in serum BAs probably had little or no impact on insulin sensitivity improvement at 4 days post-surgery.

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Biliopancreatic limb plays an important role in metabolic improvement after duodenal–jejunal bypass in a rat model of diabetes

Cited by 52 publications

References 46 publications

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Dominant gut Prevotella copri in gastrectomised non-obese diabetic Goto–Kakizaki rats improves glucose homeostasis through enhanced FXR signalling

Evidence That the Length of Bile Loop Determines Serum Bile Acid Concentration and Glycemic Control After Bariatric Surgery

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