Early Increases in Bile Acids Post Roux-en-Y Gastric Bypass Are Driven by Insulin-Sensitizing, Secondary Bile Acids
Early Increases in Bile Acids Post Roux-en-Y Gastric Bypass Are Driven by Insulin-Sensitizing, Secondary Bile Acids
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DOI：
10.1210/jc.2015-2467
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发表时间：
2015-09-01
影响因子：
5.8
通讯作者：
Abumrad, Naji N.
中科院分区：
文献类型：
--
作者：
Albaugh, Vance L.;Flynn, Charles Robb;Abumrad, Naji N.
背景：Roux-en-Y胃旁路术(RYGB)是治疗病态肥胖和解决糖尿病最有效的方法。在过去的十年里，人们普遍认为糖尿病的这种解决发生在显著的体重减轻之前；然而，这种效果背后的机制仍然不清楚，可能代表着肥胖和糖尿病的新治疗靶点。胆汁酸已被认为是这些减肥非依赖性效应的媒介。目的：确定RYGB术后胆汁酸的纵向变化，这可能为RYGB的减肥非依赖性效应提供机制洞察。设计：干预前后的观察性研究。地点：学术医学中心。患者/参与者：RYGB术前和术后1、6、12和24个月的样本收集。干预：RYGB。主要观察指标：术前、术后1、6、12和24个月测量17种胆汁酸。结果：RYGB治疗后空腹血浆总胆汁酸升高，但呈双峰型，且仅在1h出现(P<0.05)。
Context: Roux-en-Y gastric bypass (RYGB) is the most effective treatment for morbid obesity and resolution of diabetes. Over the last decade, it has become well accepted that this resolution of diabetes occurs before significant weight loss; however, the mechanisms behind this effect remain unknown and could represent novel therapeutic targets for obesity and diabetes. Bile acids have been identified as putative mediators of these weight loss-independent effects.Objective: To identify the longitudinal changes in bile acids after RYGB, which may provide mechanistic insight into the weight loss-independent effects of RYGB.Design: Observational study before/after intervention.Setting: Academic medical center.Patients/Participants: Samples were collected from morbidly obese patients (n = 21) before and after RYGB.Intervention: RYGB.Main Outcome Measures: Seventeen individual bile acid species were measured preoperatively and at 1, 6, 12, and 24 months postoperatively. Anthropometric, hormonal, and hyperinsulinemiceuglycemic clamp data were also examined to identify physiological parameters associated with bile acid changes.Results: Fasting total plasma bile acids increased after RYGB; however, increases were bimodal and were observed only at 1 (P