Abstract
Introduction:
Gastric bypass surgery (GBP) leads to sustained weight loss and significant improvement in type 2 diabetes (T2DM). Bile acids (BAs), signaling molecules which influence glucose metabolism, are a potential mediator for the improvement in T2DM after GBP. This study sought to investigate the effect of GBP on BA levels and composition in individuals with T2DM.
Methods:
Plasma BA levels and composition and fibroblast growth factor (FGF)-19 levels were measured during fasting and in response to an oral glucose load before and at 1 month and 2 years post GBP in 13 severely obese women with T2DM.
Results:
A striking temporal change in BA levels and composition was observed after GBP. During the fasted state, BA concentrations were generally reduced at 1 month, but increased 2 years post GBP. Postprandial BA levels were unchanged 1 month post GBP, but an exaggerated postprandial peak was observed 2 years after the surgery. A significant increase in the 12α-hydroxylated/non12α-hydroxylated BA ratio during fasting and postprandially at 2 years, but not 1 month, post GBP was observed. Significant correlations between BAs vs FGF-19, body weight, the incretin effect and peptide YY (PYY) were also found.
Conclusions:
This study provides evidence that GBP temporally modifies the concentration and composition of circulating BAs in individuals with T2DM, and suggests that BAs may be linked to the improvement in T2DM after GBP.
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Acknowledgements
We thank our participants, Yim Dam and Ping Zhou (technicians from the NYONRC Hormonal Core laboratory), and the entire GCRC-CTSA staff. This work was funded by grants from the American Diabetes Association (CR-7-05 CR-18) and NIH (R01-DK067561, P30-DK26687, P30-DK063608). This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1 TR000040, formerly the National Center for Research Resources, grant number UL1 RR024156. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. RD was supported by the NYONRC training grant 5T32DK007559-22. ClR received funding from Science Foundation Ireland 12/YI/B2480.
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Dutia, R., Embrey, M., O'Brien, S. et al. Temporal changes in bile acid levels and 12α-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes 39, 806–813 (2015). https://doi.org/10.1038/ijo.2015.1
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DOI: https://doi.org/10.1038/ijo.2015.1
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