Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery

Malin Werling; Royce Vincent; Gemma F. Cross; Hanns-Ulrich Marschall; Lars Fandriks; Hans Lonroth; David R. Taylor; Jamshid Alaghband-Zadeh; Torsten Olbers; Carel W. Le Roux

doi:10.3109/00365521.2013.833647

Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery

Malin Werling, Royce Vincent, Gemma F. Cross, Hanns-Ulrich Marschall, Lars Fandriks, Hans Lonroth, David R. Taylor, Jamshid Alaghband-Zadeh, Torsten Olbers, Carel W. Le Roux

Research output: Contribution to journal › Article › peer-review

66 Citations (Scopus)

Abstract

Objective. 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. Material and methods. 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. Results. 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 P <0.001. Fasting total BAs, GLP-1 and PYY increased after RYGB; 1.69 (0.70-2.56) mu mol/L to 2.43 (1.23-3.82) mu mol/L (P = 0.02), 6.8 (1.5-15.3) pmol/L to 17.1 (12.623.9) pmol/L (P <0.001) and 4.0 (1.0-7.1) pmol/L to 15.2 (10.0-28.3) pmol/L (P <0.001), 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) mmol/L/min versus 1012 (684-1921) mu mol/L/min, 315 (221-466) mu mol/L/min versus 686 (424-877) mu mol/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 P <0.0001. Conclusion. 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.

Original language	English
Pages (from-to)	1257-1264
Number of pages	8
Journal	Scandinavian Journal of Gastroenterology
Volume	48
Issue number	11
DOIs	https://doi.org/10.3109/00365521.2013.833647
Publication status	Published - Nov 2013

Keywords

bile acids
obesity
Roux-en-Y bypass
CHOLESTEROL 7-ALPHA-HYDROXYLASE GENE
GROWTH-FACTOR 19
BARIATRIC SURGERY
INSULIN-SECRETION
DIABETES REMISSION
RECEPTOR TGR5
WEIGHT-LOSS
BETA-CELLS
GLUCOSE
METABOLISM

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3109/00365521.2013.833647

Cite this

@article{d5ded17fcde6400fb2c9a1b3eee9898d,

title = "Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery",

abstract = "Objective. 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. Material and methods. 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. Results. 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 P <0.001. Fasting total BAs, GLP-1 and PYY increased after RYGB; 1.69 (0.70-2.56) mu mol/L to 2.43 (1.23-3.82) mu mol/L (P = 0.02), 6.8 (1.5-15.3) pmol/L to 17.1 (12.623.9) pmol/L (P <0.001) and 4.0 (1.0-7.1) pmol/L to 15.2 (10.0-28.3) pmol/L (P <0.001), 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) mmol/L/min versus 1012 (684-1921) mu mol/L/min, 315 (221-466) mu mol/L/min versus 686 (424-877) mu mol/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 P <0.0001. Conclusion. 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.",

keywords = "bile acids, obesity, Roux-en-Y bypass, CHOLESTEROL 7-ALPHA-HYDROXYLASE GENE, GROWTH-FACTOR 19, BARIATRIC SURGERY, INSULIN-SECRETION, DIABETES REMISSION, RECEPTOR TGR5, WEIGHT-LOSS, BETA-CELLS, GLUCOSE, METABOLISM",

author = "Malin Werling and Royce Vincent and Cross, {Gemma F.} and Hanns-Ulrich Marschall and Lars Fandriks and Hans Lonroth and Taylor, {David R.} and Jamshid Alaghband-Zadeh and Torsten Olbers and {Le Roux}, {Carel W.}",

year = "2013",

month = nov,

doi = "10.3109/00365521.2013.833647",

language = "English",

volume = "48",

pages = "1257--1264",

journal = "Scandinavian Journal of Gastroenterology",

issn = "0036-5521",

publisher = "Informa Healthcare",

number = "11",

}

TY - JOUR

T1 - Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery

AU - Werling, Malin

AU - Vincent, Royce

AU - Cross, Gemma F.

AU - Marschall, Hanns-Ulrich

AU - Fandriks, Lars

AU - Lonroth, Hans

AU - Taylor, David R.

AU - Alaghband-Zadeh, Jamshid

AU - Olbers, Torsten

AU - Le Roux, Carel W.

PY - 2013/11

Y1 - 2013/11

N2 - Objective. 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. Material and methods. 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. Results. 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 P <0.001. Fasting total BAs, GLP-1 and PYY increased after RYGB; 1.69 (0.70-2.56) mu mol/L to 2.43 (1.23-3.82) mu mol/L (P = 0.02), 6.8 (1.5-15.3) pmol/L to 17.1 (12.623.9) pmol/L (P <0.001) and 4.0 (1.0-7.1) pmol/L to 15.2 (10.0-28.3) pmol/L (P <0.001), 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) mmol/L/min versus 1012 (684-1921) mu mol/L/min, 315 (221-466) mu mol/L/min versus 686 (424-877) mu mol/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 P <0.0001. Conclusion. 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.

AB - Objective. 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. Material and methods. 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. Results. 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 P <0.001. Fasting total BAs, GLP-1 and PYY increased after RYGB; 1.69 (0.70-2.56) mu mol/L to 2.43 (1.23-3.82) mu mol/L (P = 0.02), 6.8 (1.5-15.3) pmol/L to 17.1 (12.623.9) pmol/L (P <0.001) and 4.0 (1.0-7.1) pmol/L to 15.2 (10.0-28.3) pmol/L (P <0.001), 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) mmol/L/min versus 1012 (684-1921) mu mol/L/min, 315 (221-466) mu mol/L/min versus 686 (424-877) mu mol/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 P <0.0001. Conclusion. 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.

KW - bile acids

KW - obesity

KW - Roux-en-Y bypass

KW - CHOLESTEROL 7-ALPHA-HYDROXYLASE GENE

KW - GROWTH-FACTOR 19

KW - BARIATRIC SURGERY

KW - INSULIN-SECRETION

KW - DIABETES REMISSION

KW - RECEPTOR TGR5

KW - WEIGHT-LOSS

KW - BETA-CELLS

KW - GLUCOSE

KW - METABOLISM

U2 - 10.3109/00365521.2013.833647

DO - 10.3109/00365521.2013.833647

M3 - Article

SN - 0036-5521

VL - 48

SP - 1257

EP - 1264

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

IS - 11

ER -

Enhanced fasting and post-prandial plasma bile acid responses after Roux-en-Y gastric bypass surgery

Abstract

Keywords

UN SDGs

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