Abstract
Background: Bile acids have been proposed as key mediators of the metabolic effects after bariatric surgery. Currently no reports on bile acid profiles after duodenal switch exist, and long-term data after gastric bypass are lacking.
Objective: To investigate bile acid profiles up to 5 years after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch, and to explore the relationship between bile acids and weight loss, lipid profile and glucose metabolism.
Settings: Two Scandinavian University Hospitals. Methods We present data from a randomized, clinical trial of 60 patients with body mass index 50–60 kg/m2 operated with gastric bypass or duodenal switch. Repeated measurements of total and individual bile acids from fasting serum during 5 years after surgery were performed.
Results: Mean concentrations of total bile acids increased from 2.3 µmol/L (95% CI, -0.1 to 4.7) at baseline to 5.9 µmol/L (3.5 to 8.3) 5 years after gastric bypass and from 1.0 µmol/L (95% CI, -1.4 to 3.5) to 9.5 µmol/L (95% CI, 7.1 to 11.9) after duodenal switch, mean between-group difference was -4.8 µmol/L (95% CI, -9.3 to -0.3), P=.036. Mean concentrations of primary bile acids increased more after duodenal switch, while secondary bile acids increased proportionally across the groups. Higher levels of total bile acids at 5 years were associated with lower body mass index, greater weight loss and lower total cholesterol.
Conclusions: Total bile acid concentrations increased substantially over 5 years after both gastric bypass and duodenal switch, with greater increases in total and primary bile acids after duodenal switch.
Objective: To investigate bile acid profiles up to 5 years after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch, and to explore the relationship between bile acids and weight loss, lipid profile and glucose metabolism.
Settings: Two Scandinavian University Hospitals. Methods We present data from a randomized, clinical trial of 60 patients with body mass index 50–60 kg/m2 operated with gastric bypass or duodenal switch. Repeated measurements of total and individual bile acids from fasting serum during 5 years after surgery were performed.
Results: Mean concentrations of total bile acids increased from 2.3 µmol/L (95% CI, -0.1 to 4.7) at baseline to 5.9 µmol/L (3.5 to 8.3) 5 years after gastric bypass and from 1.0 µmol/L (95% CI, -1.4 to 3.5) to 9.5 µmol/L (95% CI, 7.1 to 11.9) after duodenal switch, mean between-group difference was -4.8 µmol/L (95% CI, -9.3 to -0.3), P=.036. Mean concentrations of primary bile acids increased more after duodenal switch, while secondary bile acids increased proportionally across the groups. Higher levels of total bile acids at 5 years were associated with lower body mass index, greater weight loss and lower total cholesterol.
Conclusions: Total bile acid concentrations increased substantially over 5 years after both gastric bypass and duodenal switch, with greater increases in total and primary bile acids after duodenal switch.
| Original language | English |
|---|---|
| Journal | Surgery for obesity and related diseases |
| DOIs | |
| Publication status | E-pub ahead of print - 25 May 2017 |
Keywords
- Bariatric surgery
- metabolic surgery
- Roux-en-Y gastric bypass
- gastric bypass, biliopancreatic diversion with duodenal switch
- duodenal switch
- randomized controlled trial
- randomized clinical trial
- bile acids, bile acid profiles