Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism.
Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism.
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DOI：
10.1038/oby.2009.102
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发表时间：
2009-09
期刊：
影响因子：
--
通讯作者：
Goldfine AB
中科院分区：
文献类型：
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作者：
Patti ME;Houten SM;Bianco AC;Bernier R;Larsen PR;Holst JJ;Badman MK;Maratos-Flier E;Mun EC;Pihlajamaki J;Auwerx J;Goldfine AB
促进Roux-en-Y胃旁路术（GB）后体重减轻和代谢改善的多因素机制仍不完全清楚。最近的啮齿动物研究表明，胆汁酸可以通过激活G蛋白偶联受体TGR 5和2型甲状腺激素脱碘酶来介导能量稳态。GB后胃肠道解剖结构的改变可能影响胆汁酸的肝肠再循环。我们评估了循环胆汁酸浓度是否与既往接受GB的患者不同，这可能有助于改善代谢稳态。我们对三个受试者组的空腹血清胆汁酸组成以及空腹和餐后代谢变量进行了横断面分析：（i）GB手术后（n = 9），（ii）与索引队列术前BMI匹配的无GB（n = 5），（iii）与索引队列当前BMI匹配的无GB（n = 10）。GB组血清总胆汁酸浓度（8.90 ± 4.84 µmol/l）高于超重组（3.59 ± 1.95，P = 0.005，Ov）和重度肥胖组（3.86 ± 1.51，P = 0.045，MOb）。胆汁酸亚组分牛磺鹅去氧胆酸、牛磺去氧胆酸、甘氨胆酸、甘氨鹅去氧胆酸和甘氨脱氧胆酸在GB中均显著高于Ov（P < 0.05）。总胆汁酸与餐后2小时血糖（r =-0.59，P < 0.003）和空腹甘油三酯（r =-0.40，P = 0.05）呈负相关，与脂联素（r =-0.48，P < 0.02）和胰高血糖素样肽-1（GLP-1）峰值（r = 0.58，P < 0.003）呈正相关。总胆汁酸与促甲状腺激素（TSH）呈显著负相关（r =-0.57，P = 0.004）。总之，我们的数据表明，胆汁酸水平和组成的改变可能有助于改善GB患者的葡萄糖和脂质代谢。
The multifactorial mechanisms promoting weight loss and improved metabolism following Roux-en-Y gastric bypass (GB) surgery remain incompletely understood. Recent rodent studies suggest that bile acids can mediate energy homeostasis by activating the G-protein coupled receptor TGR5 and the type 2 thyroid hormone deiodinase. Altered gastrointestinal anatomy following GB could affect enterohepatic recirculation of bile acids. We assessed whether circulating bile acid concentrations differ in patients who previously underwent GB, which might then contribute to improved metabolic homeostasis. We performed cross-sectional analysis of fasting serum bile acid composition and both fasting and post-meal metabolic variables, in three subject groups: (i) post-GB surgery (n = 9), (ii) without GB matched to preoperative BMI of the index cohort (n = 5), and (iii) without GB matched to current BMI of the index cohort (n = 10). Total serum bile acid concentrations were higher in GB (8.90 ± 4.84 µmol/l) than in both overweight (3.59 ± 1.95, P = 0.005, Ov) and severely obese (3.86 ± 1.51, P = 0.045, MOb). Bile acid subfractions taurochenodeoxycholic, taurodeoxycholic, glycocholic, glycochenodeoxycholic, and glycodeoxycholic acids were all significantly higher in GB compared to Ov (P < 0.05). Total bile acids were inversely correlated with 2-h post-meal glucose (r = −0.59, P < 0.003) and fasting triglycerides (r = −0.40, P = 0.05), and positively correlated with adiponectin (r = −0.48, P < 0.02) and peak glucagon-like peptide-1 (GLP-1) (r = 0.58, P < 0.003). Total bile acids strongly correlated inversely with thyrotropic hormone (TSH) (r = −0.57, P = 0.004). Together, our data suggest that altered bile acid levels and composition may contribute to improved glucose and lipid metabolism in patients who have had GB.