Increased glycine-amidated hyocholic acid correlates to improved early weight loss after sleeve gastrectomy. Surg Endosc 2018 Feb;32(2):805-812
Date
08/06/2017Pubmed ID
28779240Pubmed Central ID
PMC5844265DOI
10.1007/s00464-017-5747-yScopus ID
2-s2.0-85026804830 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
BACKGROUND: Bile acids (BAs) are post-prandial hormones that play an important role in glucose and lipid homeostasis as well as energy expenditure. Total and glycine-amidated BAs increase after sleeve gastrectomy (SG) and correlate to improved metabolic disease. No specific bile acid subtype has been shown conclusively to mediate the weight loss effect. Therefore, the objective of this study was to prospectively evaluate the comprehensive changes in meal-stimulated BAs after SG and determine if a specific change in the BA profile correlates to the early weight loss response.
METHODS: Patients were prospectively enrolled at the University of Nebraska Medical Center who were undergoing a SG for treatment of morbid obesity. Primary and secondary plasma bile acids and their amidated (glycine, G-, or taurine, T-) subtypes were measured at fasting, 30 and 60 min after a liquid meal performed pre-op, and at 6 and 12 weeks post-op. Area under the curve (AUC) was calculated for the hour meal test for each bile acid subtype. BAs that were significantly increased post-op were correlated to body mass index (BMI) loss.
RESULTS: Total BA AUC was significantly increased at 6 (p < 0.01) and 12 weeks post-op (p < 0.01) compared to pre-operative values. The increase in total BA AUC was due to a statistically significant increase in G-BAs. Nine different BA AUC subtypes were significantly increased at both 6 and 12 weeks post-op. Increased total and G-chenodeoxycholic acid AUC was significantly correlated to the 6 week BMI loss (p = 0.03). Increased G-hyocholic acid was significantly correlated to increased weight loss at both 6 (p = 0.05) and 12 weeks (p = 0.006).
CONCLUSIONS: SG induced an early and persistent post-prandial surge in multiple bile acid subtypes. Increased G-hyocholic consistently correlated with greater early BMI loss. This study provides evidence for a role of BAs in the surgical weight loss response after SG.
Author List
Kindel TL, Krause C, Helm MC, McBride CL, Oleynikov D, Thakare R, Alamoudi J, Kothari V, Alnouti Y, Kohli RAuthor
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Bile Acids and SaltsBody Mass Index
Cholic Acids
Fasting
Female
Gastrectomy
Humans
Male
Middle Aged
Postprandial Period
Prospective Studies
Weight Loss
