Roux-en-Y gastric bypass normalizes the blunted postprandial bile acid excursion associated with obesity.
Roux-en-Y gastric bypass normalizes the blunted postprandial bile acid excursion associated with obesity.
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DOI：
10.1038/ijo.2013.38
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发表时间：
2013-12
影响因子：
4.9
通讯作者：
Kaplan, L. M.
中科院分区：
文献类型：
--
作者：
Ahmad, N. N.;Pfalzer, A.;Kaplan, L. M.
胆汁酸 (BA) 是营养反应性激素，可通过细胞表面和核受体调节能量平衡。研究发现，肥胖者的餐后血浆 BA 会降低。我们的目的是确定膳食刺激的循环 BA 水平是否会通过 Roux-en-Y 胃绕道手术 (RYGB) 改变，该手术可以改变食物摄入和能量消耗的神经体液决定因素，从而导致显着且持久的体重减轻。测量 RYGB 前后空腹和餐后血浆 BA 的纵向研究。五名肥胖手术患者和八名瘦对照者在标准流质餐后进行了频繁的血液采样。肥胖受试者也在 RYGB 后 1、4 和 40 周进行了测试。通过反相高效液相色谱/质谱法测量初级和次级循环 BA 及其甘氨酸和牛磺酸缀合物。通过曲线下面积 (AUC) 分析，我们发现肥胖个体中结合 BA 的餐后偏移比瘦个体低 52.4%（分别为 378 µmol min l−1 和 793 µmol min l−1，P < 0.05）。 RYGB 后 40 周，膳食引起的结合 BA 增加了 55.5%，达到健康瘦对照的水平（根据 AUC 分析，术前 378 µmol min l− 术后为 850 µmol min l−，P < 0.05）。相比之下，瘦人和肥胖者餐后未结合的 BA 浓度相似，并且不受手术影响。鉴于越来越多的证据表明 BA 在葡萄糖、脂质和能量稳态中发挥着关键作用，RYGB 使肥胖中迟钝的餐后循环 BA 反应正常化的观察结果表明，BA 可能有助于 RYGB 后观察到的与膳食相关的生理学的改善。需要进一步的研究来检验这一假设，并确定 BA 对营养摄入的增强反应可能在多大程度上介导肠促胰岛素反应增加、棕色脂肪组织活化和手术后观察到的喂养热效应。
Bile acids (BAs) are nutrient-responsive hormones that modulate energy balance through cell surface and nuclear receptors. Postprandial plasma BAs have been found to be decreased in obesity. We aimed to determine whether meal-stimulated circulating BA levels are altered by Roux-en-Y gastric bypass (RYGB), an operation that modifies the neurohumoral determinants of food intake and energy expenditure to cause significant and durable weight loss. Longitudinal study measuring fasting and postprandial plasma BAs before and after RYGB. Five obese surgical patients and eight lean controls underwent frequent blood sampling after a standard liquid meal. Obese subjects were also tested at 1, 4 and 40 weeks after RYGB. Primary and secondary circulating BAs, as well as their glycine and taurine conjugates, were measured via reverse-phase high-performance liquid chromatography/mass spectroscopy. We found that postprandial excursion of conjugated BAs was 52.4% lower in obese than in lean individuals by area-under-the-curve (AUC) analysis (378 vs 793 µmol min l−1, respectively, P < 0.05). By 40 weeks after RYGB, the meal-induced rise in conjugated BAs increased by 55.5% to the level of healthy lean controls (378 pre-op vs 850 µmol min l− post-op by AUC analyses, P < 0.05). In contrast, postprandial concentrations of unconjugated BAs were similar in lean and obese individuals and were not affected by surgery. In light of the growing evidence that BAs have key roles in glucose, lipid and energy homeostasis, the observation that RYGB normalizes the blunted postprandial circulating BA response in obesity suggests that BAs may contribute to the improvement in meal-related physiology seen after RYGB. Further studies are warranted to examine this hypothesis and to determine the degree to which an augmented BA response to nutrient ingestion may mediate the increased incretin response, brown adipose tissue activation and thermic effect of feeding that has been observed after this operation.
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影响因子：
2.2
作者：
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通讯作者：
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DOI：
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通讯作者：
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