Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery
| Autor: | Jamshid Alaghband-Zadeh, Hans Lönroth, Carel W. le Roux, Hanns-Ulrich Marschall, Torsten Olbers, Gemma F. Cross, Royce P Vincent, Malin Werling, Lars Fändriks, David R Taylor |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Time Factors medicine.drug_class medicine.medical_treatment Gastric Bypass medicine.disease_cause Body Mass Index Cohort Studies Glucagon-Like Peptide 1 Weight loss Internal medicine Weight Loss medicine Bile Humans Insulin Obesity Prospective cohort study Meal Bile acid business.industry Gastric bypass surgery digestive oral and skin physiology Gastroenterology nutritional and metabolic diseases Fasting Middle Aged Postprandial Period Roux-en-Y anastomosis C-Reactive Protein Endocrinology Female Insulin Resistance medicine.symptom business Body mass index |
| Zdroj: | Scandinavian Journal of Gastroenterology. 48:1257-1264 |
| ISSN: | 1502-7708 0036-5521 3162-4537 |
| DOI: | 10.3109/00365521.2013.833647 |
| Popis: | Exogenous bile acid (BA) administration is associated with beneficial metabolic effects very similar to those seen after Roux-en-Y gastric bypass (RYGB) surgery. Re-routing of bile into a biliopancreatic limb with simultaneous exclusion of food occurs after RYGB, with subsequent increased fasting plasma BAs. The study assessed fasting and post-prandial plasma BA response before and 15 months after RYGB.The prospective study recruited 63 obese individuals (43 females), aged 43 (36-56) [median (IQR)] years. Blood samples were collected before and every 30 min for 120 min after a standard 400 kcal meal. Fasting and post-prandial plasma BAs, glucagons like peptide-1 (GLP-1), -tyrosine (PYY), fasting C-reactive protein (CRP), glucose and insulin were measured and homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.Following RYGB, body mass index, CRP, fasting glucose and HOMA-IR decreased; 43.7 (39.3-49.2) kg/m(2) to 29.2 (25.1-35.0) kg/m(2), 7.9 (4.1-11.9) mg/L to 0.4 (0.2-1.0) mg/L, 5.5 (5.0-6.0) mmol/L to 4.6 (4.3-4.9) mmol/L and 5.9 (3.5-9.2) to 1.7 (1.1-2.2), respectively, all P0.001. Fasting total BAs, GLP-1 and PYY increased after RYGB; 1.69 (0.70-2.56) µmol/L to 2.43 (1.23-3.82) µmol/L (P = 0.02), 6.8 (1.5-15.3) pmol/L to 17.1 (12.6-23.9) pmol/L (P0.001) and 4.0 (1.0-7.1) pmol/L to 15.2 (10.0-28.3) pmol/L (P0.001), respectively. The area under the curve for post-prandial total BAs, total glycine-conjugated BAs, GLP-1 and PYY were greater after RYGB; 486 (312-732) µmol/L/min versus 1012 (684-1921) µmol/L/min, 315 (221-466) µmol/L/min versus 686 (424-877) µmol/L/min, 3679 (3162-4537) pmol/L/min versus 5347 (4727-5781) pmol/L/min and 1887 (1423-2092) pmol/L/min versus 3296 (2534-3834) pmol/L/min, respectively, all P0.0001.Weight loss following RYGB is associated with an increase in post-prandial plasma BA response due to larger amounts of glycine-conjugated BAs. This suggests up regulation of BA production and conjugation after RYGB. |
| Databáze: | OpenAIRE |
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