Bile acids and bariatric surgery.
Bile acids and bariatric surgery.
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DOI：
10.1016/j.mam.2017.04.001
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发表时间：
2017-08
影响因子：
10.6
通讯作者：
Flynn CR
中科院分区：
文献类型：
--
作者：
Albaugh VL;Banan B;Ajouz H;Abumrad NN;Flynn CR
减肥手术，特别是 Roux-en-Y 胃绕道手术 (RYGB) 和垂直袖状胃切除术 (VSG)，是治疗病态肥胖最有效、最持久的治疗方法，并且可能是治疗 2 型糖尿病 (T2D) 的可行方法。经过这些手术后，T2D 的解决率在 40-80% 之间，远远超过单独的医疗管理所达到的效果。这种改善的分子基础尚不完全清楚，但部分归因于胆汁酸肠肝循环的改变。在这篇综述中，我们强调胆汁酸如何可能有助于改善这些手术后的脂质和葡萄糖稳态、胰岛素敏感性和能量消耗。肠肝循环中胆汁酸水平改变的影响也与肠道微生物群的变化有关，这可能进一步促进其中一些有益作用。我们强调了实验性外科手术对啮齿类动物的有益影响，这些手术改变了胆汁分泌流，而不限制胃或改变营养流。这一信息表明，胆汁酸除了膳食脂肪乳化之外，在强烈改变全身葡萄糖和脂质代谢方面也发挥着作用，还表明了胆汁酸受体法尼醇x受体（FXR）和G蛋白偶联胆汁酸受体（TGR5）的激活在这些改善中的新作用。回顾了啮齿动物研究的局限性和我们目前的理解状态，并严格检查了胆汁酸介导减肥手术后短期和长期代谢改善的潜在影响。
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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影响因子：
2.9
作者：
Arterburn DE;Bogart A;Sherwood NE;Sidney S;Coleman KJ;Haneuse S;O'Connor PJ;Theis MK;Campos GM;McCulloch D;Selby J
通讯作者：
Selby J
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2.6
作者：
Adams, Ted D.;Hunt, Steven C.
通讯作者：
Hunt, Steven C.
影响因子：
9.8
作者：
ANDERSEN, E;HELLSTROM, K
通讯作者：
HELLSTROM, K
影响因子：
2.9
作者：
Belgaumkar, Ajay P.;Vincent, Royce P.;Patel, Ameet G.
通讯作者：
Patel, Ameet G.
影响因子：
4.9
作者：
Ahmad, N. N.;Pfalzer, A.;Kaplan, L. M.
通讯作者：
Kaplan, L. M.