Bile acids and gut peptide secretion after bariatric surgery: A 1-year prospective randomized pilot trial
Bile acids and gut peptide secretion after bariatric surgery: A 1-year prospective randomized pilot trial
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DOI：
10.1002/oby.20522
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发表时间：
2013-12-01
期刊：
影响因子：
6.9
通讯作者：
Beglinger, Christoph
中科院分区：
文献类型：
--
作者：
Steinert, Robert E.;Peterli, Ralph;Beglinger, Christoph
目的肥胖症患者术后早期肠肽分泌显著增加，胆汁酸盐(BA)向远端L细胞递送增多和TGR5受体激活改变可能与此有关。为了进一步阐明BA在GLP-1和PYY分泌中的潜在作用，我们在一项为期一年的前瞻性随机试验中分析了14名接受胃旁路手术或袖状胃切除术的病态肥胖患者的血浆BA浓度。设计和方法患者接受标准的试验餐，并在进食前和进食后、手术前、术后1周、3个月和12个月采集血液。结果手术前，肥胖组基础BA浓度显著低于健康对照组。术后一年，减肥患者的BA浓度有不同程度的升高(胃旁路手术患者的BA浓度增加了近2倍，P<0.05)。然而，虽然在两组患者中，GLP-1和PYY在手术后1周和3个月就显著增加，血糖控制得到改善，但血浆BA的变化遵循不同的模式：基础和餐后血浆BA浓度的增加要慢得多，进展更快，仅在手术后1年显著增加。结论基于这些发现，BA似乎不是减肥后患者早期GLP-1和PYY反应增加的关键介质。
Objective Increased delivery of bile acid salts (BA) to distal L-cells and altered TGR5 receptor activation may contribute to the early and substantial increases in gut peptide secretion seen after bariatric surgery. To further elucidate a potential role of BA in the secretion of GLP-1 and PYY, we analyzed plasma BA concentrations in 14 morbidly obese patients undergoing gastric bypass or sleeve gastrectomy in a prospective, randomized 1-year trial. Design and Methods Patients received a standard test meal and blood was collected before and after eating, prior to, and 1 week, 3 months, and 12 months after surgery. Results Pre-surgery, basal BA concentrations were significantly lower in bariatric patients than in healthy controls. One year post-surgery, bariatric patients expressed variably increased BA concentrations (gastric bypass patients approximate to 2 fold increase, P0.05). However, whereas in both patient groups, marked increases in GLP-1 and PYY and improved glycemic control was seen already 1 week and 3 months post-surgery, changes in plasma BA followed a different pattern: basal and postprandial plasma BA concentrations increased much slower, more progressively with significant increases only 1-year post-surgery. Conclusions Based on these findings, BA do not appear to be key mediators of the early increase in GLP-1 and PYY response in post-bariatric patients.