The Role of Bile After Roux-en-Y Gastric Bypass in Promoting Weight Loss and Improving Glycaemic Control

Dimitri J. Pournaras; Clare Glicksman; Royce Vincent; Shophia Kuganolipava; Jamie Alaghband-Zadeh; David Mahon; Jan H. R. Bekker; Mohammad A. Ghatei; Stephen R. Bloom; Julian R. F. Walters; Richard Welbourn; Carel W. le Roux

doi:10.1210/en.2011-2145

The Role of Bile After Roux-en-Y Gastric Bypass in Promoting Weight Loss and Improving Glycaemic Control

Dimitri J. Pournaras, Clare Glicksman, Royce Vincent, Shophia Kuganolipava, Jamie Alaghband-Zadeh, David Mahon, Jan H. R. Bekker, Mohammad A. Ghatei, Stephen R. Bloom, Julian R. F. Walters, Richard Welbourn^*, Carel W. le Roux

^*Corresponding author for this work

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

315 Citations (Scopus)

Abstract

Gastric bypass leads to the remission of type 2 diabetes independently of weight loss. Our hypothesis is that changes in bile flow due to the altered anatomy may partly explain the metabolic outcomes of the operation. We prospectively studied 12 patients undergoing gastric bypass and six patients undergoing gastric banding over a 6-wk period. Plasma fibroblast growth factor (FGF)19, stimulated by bile acid absorption in the terminal ileum, and plasma bile acids were measured. In canine and rodent models, we investigated changes in the gut hormone response after altered bile flow. FGF19 and total plasma bile acids levels increased after gastric bypass compared with no change after gastric banding. In the canine model, both food and bile, on their own, stimulated satiety gut hormone responses. However, when combined, the response was doubled. In rats, drainage of endogenous bile into the terminal ileum was associated with an enhanced satiety gut hormone response, reduced food intake, and lower body weight. In conclusion, after gastric bypass, bile flow is altered, leading to increased plasma bile acids, FGF19, incretin. and satiety gut hormone concentrations. Elucidating the mechanism of action of gastric bypass surgery may lead to novel treatments for type 2 diabetes.

Original language	English
Pages (from-to)	3613-3619
Number of pages	7
Journal	Endocrinology
Volume	153
Issue number	8
DOIs	https://doi.org/10.1210/en.2011-2145
Publication status	Published - Aug 2012

Keywords

TYPE-2 DIABETES-MELLITUS
FARNESOID-X-RECEPTOR
PEPTIDE-YY
ENERGY-EXPENDITURE
GLUCOSE-METABOLISM
BARIATRIC SURGERY
OBESE SUBJECTS
GUT HORMONES
ACIDS
THERAPY

UN SDGs

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

Access to Document

10.1210/en.2011-2145

Cite this

Pournaras, D. J., Glicksman, C., Vincent, R., Kuganolipava, S., Alaghband-Zadeh, J., Mahon, D., Bekker, J. H. R., Ghatei, M. A., Bloom, S. R., Walters, J. R. F., Welbourn, R., & le Roux, C. W. (2012). The Role of Bile After Roux-en-Y Gastric Bypass in Promoting Weight Loss and Improving Glycaemic Control. Endocrinology, 153(8), 3613-3619. https://doi.org/10.1210/en.2011-2145

@article{ea7141b3580a454eb49a17cc791adb50,

title = "The Role of Bile After Roux-en-Y Gastric Bypass in Promoting Weight Loss and Improving Glycaemic Control",

abstract = "Gastric bypass leads to the remission of type 2 diabetes independently of weight loss. Our hypothesis is that changes in bile flow due to the altered anatomy may partly explain the metabolic outcomes of the operation. We prospectively studied 12 patients undergoing gastric bypass and six patients undergoing gastric banding over a 6-wk period. Plasma fibroblast growth factor (FGF)19, stimulated by bile acid absorption in the terminal ileum, and plasma bile acids were measured. In canine and rodent models, we investigated changes in the gut hormone response after altered bile flow. FGF19 and total plasma bile acids levels increased after gastric bypass compared with no change after gastric banding. In the canine model, both food and bile, on their own, stimulated satiety gut hormone responses. However, when combined, the response was doubled. In rats, drainage of endogenous bile into the terminal ileum was associated with an enhanced satiety gut hormone response, reduced food intake, and lower body weight. In conclusion, after gastric bypass, bile flow is altered, leading to increased plasma bile acids, FGF19, incretin. and satiety gut hormone concentrations. Elucidating the mechanism of action of gastric bypass surgery may lead to novel treatments for type 2 diabetes.",

keywords = "TYPE-2 DIABETES-MELLITUS, FARNESOID-X-RECEPTOR, PEPTIDE-YY, ENERGY-EXPENDITURE, GLUCOSE-METABOLISM, BARIATRIC SURGERY, OBESE SUBJECTS, GUT HORMONES, ACIDS, THERAPY",

author = "Pournaras, {Dimitri J.} and Clare Glicksman and Royce Vincent and Shophia Kuganolipava and Jamie Alaghband-Zadeh and David Mahon and Bekker, {Jan H. R.} and Ghatei, {Mohammad A.} and Bloom, {Stephen R.} and Walters, {Julian R. F.} and Richard Welbourn and {le Roux}, {Carel W.}",

year = "2012",

month = aug,

doi = "10.1210/en.2011-2145",

language = "English",

volume = "153",

pages = "3613--3619",

journal = "Endocrinology",

issn = "0013-7227",

publisher = "The Endocrine Society",

number = "8",

}

TY - JOUR

T1 - The Role of Bile After Roux-en-Y Gastric Bypass in Promoting Weight Loss and Improving Glycaemic Control

AU - Pournaras, Dimitri J.

AU - Glicksman, Clare

AU - Vincent, Royce

AU - Kuganolipava, Shophia

AU - Alaghband-Zadeh, Jamie

AU - Mahon, David

AU - Bekker, Jan H. R.

AU - Ghatei, Mohammad A.

AU - Bloom, Stephen R.

AU - Walters, Julian R. F.

AU - Welbourn, Richard

AU - le Roux, Carel W.

PY - 2012/8

Y1 - 2012/8

N2 - Gastric bypass leads to the remission of type 2 diabetes independently of weight loss. Our hypothesis is that changes in bile flow due to the altered anatomy may partly explain the metabolic outcomes of the operation. We prospectively studied 12 patients undergoing gastric bypass and six patients undergoing gastric banding over a 6-wk period. Plasma fibroblast growth factor (FGF)19, stimulated by bile acid absorption in the terminal ileum, and plasma bile acids were measured. In canine and rodent models, we investigated changes in the gut hormone response after altered bile flow. FGF19 and total plasma bile acids levels increased after gastric bypass compared with no change after gastric banding. In the canine model, both food and bile, on their own, stimulated satiety gut hormone responses. However, when combined, the response was doubled. In rats, drainage of endogenous bile into the terminal ileum was associated with an enhanced satiety gut hormone response, reduced food intake, and lower body weight. In conclusion, after gastric bypass, bile flow is altered, leading to increased plasma bile acids, FGF19, incretin. and satiety gut hormone concentrations. Elucidating the mechanism of action of gastric bypass surgery may lead to novel treatments for type 2 diabetes.

AB - Gastric bypass leads to the remission of type 2 diabetes independently of weight loss. Our hypothesis is that changes in bile flow due to the altered anatomy may partly explain the metabolic outcomes of the operation. We prospectively studied 12 patients undergoing gastric bypass and six patients undergoing gastric banding over a 6-wk period. Plasma fibroblast growth factor (FGF)19, stimulated by bile acid absorption in the terminal ileum, and plasma bile acids were measured. In canine and rodent models, we investigated changes in the gut hormone response after altered bile flow. FGF19 and total plasma bile acids levels increased after gastric bypass compared with no change after gastric banding. In the canine model, both food and bile, on their own, stimulated satiety gut hormone responses. However, when combined, the response was doubled. In rats, drainage of endogenous bile into the terminal ileum was associated with an enhanced satiety gut hormone response, reduced food intake, and lower body weight. In conclusion, after gastric bypass, bile flow is altered, leading to increased plasma bile acids, FGF19, incretin. and satiety gut hormone concentrations. Elucidating the mechanism of action of gastric bypass surgery may lead to novel treatments for type 2 diabetes.

KW - TYPE-2 DIABETES-MELLITUS

KW - FARNESOID-X-RECEPTOR

KW - PEPTIDE-YY

KW - ENERGY-EXPENDITURE

KW - GLUCOSE-METABOLISM

KW - BARIATRIC SURGERY

KW - OBESE SUBJECTS

KW - GUT HORMONES

KW - ACIDS

KW - THERAPY

U2 - 10.1210/en.2011-2145

DO - 10.1210/en.2011-2145

M3 - Article

SN - 0013-7227

VL - 153

SP - 3613

EP - 3619

JO - Endocrinology

JF - Endocrinology

IS - 8

ER -

The Role of Bile After Roux-en-Y Gastric Bypass in Promoting Weight Loss and Improving Glycaemic Control

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this