Increased Bile Acids and FGF19 After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Correlate with Improvement in Type 2 Diabetes in a Randomized Trial
| Autor: | Reza Nemati, Michael Booth, Jun Lu, Dech Dokpuang, Lindsay D. Plank, Rinki Murphy |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Sleeve gastrectomy medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastric Bypass 030209 endocrinology & metabolism Type 2 diabetes Gastroenterology law.invention Bile Acids and Salts 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Weight loss Gastrectomy Diabetes mellitus Internal medicine Weight Loss medicine Humans 030212 general & internal medicine Obesity Nutrition and Dietetics business.industry nutritional and metabolic diseases FGF19 medicine.disease Roux-en-Y anastomosis Fibroblast Growth Factors Diabetes Mellitus Type 2 Surgery medicine.symptom business Follow-Up Studies |
| Zdroj: | Obesity surgery. 28(9) |
| ISSN: | 1708-0428 |
| Popis: | Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are both effective bariatric procedures to treat type 2 diabetes (T2DM) and obesity. The contribution of changes in bile acids (BAs) and fibroblast growth factor19 (FGF19) to such metabolic improvements is unclear.We examined associations between changes in BAs, FGF19 (fasting and prandial), with changes in body weight, glycemia, and other metabolic variables in 61 obese patients with T2DM before and 1 year after randomization to SG or RYGB.Weight loss and diabetes remission (defined by HbA1c 39 mmol/mol [ 5.7%] in the absence of glucose-lowering therapy) after RYGB and SG was similar (mean weight loss - 29 vs - 31 kg, p = 0.50; diabetes remission proportion 37.5 vs 34%, p = 1.0). Greater increments in fasting and prandial levels of total, secondary, and unconjugated BAs were seen after RYGB than SG. Fasting and prandial increases in total (r = - 0.3, p = 0.01; r = - 0.2, p = 0.04), secondary (r = - 0.3, p = 0.01; r = - 0.4, p = 0.01) and unconjugated BA (r = - 0.3, p = 0.01; r = 0.4, p 0.01) correlated with decreases in HbA1c, but not weight. Changes in 12α-OH/non 12α-OH were positively associated with prandial glucose increments (r = 0.2, p = 0.03), HbA1c (r = 0.3, p = 0.01), and negatively associated with changes in insulinogenc index (r = - 0.3, p = 0.01). Only changes in prandial FGF19 were negatively associated with HbA1c (r = - 0.4, p 0.01) and visceral fat (r = - 0.3, p = 0.04).The association between increases in secondary, unconjugated BAs and improvements in HBA1c (but not weight) achieved after both RYGB and SG suggest manipulation of BA as a potential strategy for controlling T2DM through weight-independent means. |
| Databáze: | OpenAIRE |
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