Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism

Mary-Elizabeth Patti; Sander M Houten; Antonio C Bianco; Raquel Bernier; P Reed Larsen; Jens J Holst; Michael K Badman; Eleftheria Maratos-Flier; Edward C Mun; Jussi Pihlajamaki; Johan Auwerx; Allison B Goldfine

doi:10.1038/oby.2009.102

Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism

Mary-Elizabeth Patti, Sander M Houten, Antonio C Bianco, Raquel Bernier, P Reed Larsen, Jens J Holst, Michael K Badman, Eleftheria Maratos-Flier, Edward C Mun, Jussi Pihlajamaki, Johan Auwerx, Allison B Goldfine

Endocrinology and Metabolism

398 Citations (Scopus)

Abstract

The multifactorial mechanisms promoting weight loss and improved metabolism following Roux-en-Y gastric bypass (GB) surgery remain incompletely understood. Recent rodent studies suggest that bile acids can mediate energy homeostasis by activating the G-protein coupled receptor TGR5 and the type 2 thyroid hormone deiodinase. Altered gastrointestinal anatomy following GB could affect enterohepatic recirculation of bile acids. We assessed whether circulating bile acid concentrations differ in patients who previously underwent GB, which might then contribute to improved metabolic homeostasis. We performed cross-sectional analysis of fasting serum bile acid composition and both fasting and post-meal metabolic variables, in three subject groups: (i) post-GB surgery (n = 9), (ii) without GB matched to preoperative BMI of the index cohort (n = 5), and (iii) without GB matched to current BMI of the index cohort (n = 10). Total serum bile acid concentrations were higher in GB (8.90 +/- 4.84 micromol/l) than in both overweight (3.59 +/- 1.95, P = 0.005, Ov) and severely obese (3.86 +/- 1.51, P = 0.045, MOb). Bile acid subfractions taurochenodeoxycholic, taurodeoxycholic, glycocholic, glycochenodeoxycholic, and glycodeoxycholic acids were all significantly higher in GB compared to Ov (P < 0.05). Total bile acids were inversely correlated with 2-h post-meal glucose (r = -0.59, P < 0.003) and fasting triglycerides (r = -0.40, P = 0.05), and positively correlated with adiponectin (r = -0.48, P < 0.02) and peak glucagon-like peptide-1 (GLP-1) (r = 0.58, P < 0.003). Total bile acids strongly correlated inversely with thyrotropic hormone (TSH) (r = -0.57, P = 0.004). Together, our data suggest that altered bile acid levels and composition may contribute to improved glucose and lipid metabolism in patients who have had GB.

Original language	English
Journal	Obesity
Volume	17
Issue number	9
Pages (from-to)	1671-7
Number of pages	6
ISSN	1930-7381
DOIs	https://doi.org/10.1038/oby.2009.102
Publication status	Published - 2009

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Patti, M-E., Houten, S. M., Bianco, A. C., Bernier, R., Larsen, P. R., Holst, J. J., Badman, M. K., Maratos-Flier, E., Mun, E. C., Pihlajamaki, J., Auwerx, J., & Goldfine, A. B. (2009). Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity, 17(9), 1671-7. https://doi.org/10.1038/oby.2009.102

@article{ab6d54b0335511df8ed1000ea68e967b,

title = "Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism",

abstract = "The multifactorial mechanisms promoting weight loss and improved metabolism following Roux-en-Y gastric bypass (GB) surgery remain incompletely understood. Recent rodent studies suggest that bile acids can mediate energy homeostasis by activating the G-protein coupled receptor TGR5 and the type 2 thyroid hormone deiodinase. Altered gastrointestinal anatomy following GB could affect enterohepatic recirculation of bile acids. We assessed whether circulating bile acid concentrations differ in patients who previously underwent GB, which might then contribute to improved metabolic homeostasis. We performed cross-sectional analysis of fasting serum bile acid composition and both fasting and post-meal metabolic variables, in three subject groups: (i) post-GB surgery (n = 9), (ii) without GB matched to preoperative BMI of the index cohort (n = 5), and (iii) without GB matched to current BMI of the index cohort (n = 10). Total serum bile acid concentrations were higher in GB (8.90 +/- 4.84 micromol/l) than in both overweight (3.59 +/- 1.95, P = 0.005, Ov) and severely obese (3.86 +/- 1.51, P = 0.045, MOb). Bile acid subfractions taurochenodeoxycholic, taurodeoxycholic, glycocholic, glycochenodeoxycholic, and glycodeoxycholic acids were all significantly higher in GB compared to Ov (P < 0.05). Total bile acids were inversely correlated with 2-h post-meal glucose (r = -0.59, P < 0.003) and fasting triglycerides (r = -0.40, P = 0.05), and positively correlated with adiponectin (r = -0.48, P < 0.02) and peak glucagon-like peptide-1 (GLP-1) (r = 0.58, P < 0.003). Total bile acids strongly correlated inversely with thyrotropic hormone (TSH) (r = -0.57, P = 0.004). Together, our data suggest that altered bile acid levels and composition may contribute to improved glucose and lipid metabolism in patients who have had GB.",

author = "Mary-Elizabeth Patti and Houten, {Sander M} and Bianco, {Antonio C} and Raquel Bernier and Larsen, {P Reed} and Holst, {Jens J} and Badman, {Michael K} and Eleftheria Maratos-Flier and Mun, {Edward C} and Jussi Pihlajamaki and Johan Auwerx and Goldfine, {Allison B}",

note = "Keywords: Adiponectin; Adult; Bile Acids and Salts; Biological Markers; Blood Glucose; Body Mass Index; Case-Control Studies; Cross-Sectional Studies; Fasting; Female; Gastric Bypass; Glucagon-Like Peptide 1; Humans; Male; Middle Aged; Obesity; Postprandial Period; Severity of Illness Index; Thyrotropin; Treatment Outcome; Triglycerides; Up-Regulation",

year = "2009",

doi = "10.1038/oby.2009.102",

language = "English",

volume = "17",

pages = "1671--7",

journal = "Obesity",

issn = "1930-7381",

publisher = "Wiley-Blackwell",

number = "9",

}

TY - JOUR

T1 - Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism

AU - Patti, Mary-Elizabeth

AU - Houten, Sander M

AU - Bianco, Antonio C

AU - Bernier, Raquel

AU - Larsen, P Reed

AU - Holst, Jens J

AU - Badman, Michael K

AU - Maratos-Flier, Eleftheria

AU - Mun, Edward C

AU - Pihlajamaki, Jussi

AU - Auwerx, Johan

AU - Goldfine, Allison B

N1 - Keywords: Adiponectin; Adult; Bile Acids and Salts; Biological Markers; Blood Glucose; Body Mass Index; Case-Control Studies; Cross-Sectional Studies; Fasting; Female; Gastric Bypass; Glucagon-Like Peptide 1; Humans; Male; Middle Aged; Obesity; Postprandial Period; Severity of Illness Index; Thyrotropin; Treatment Outcome; Triglycerides; Up-Regulation

PY - 2009

Y1 - 2009

N2 - The multifactorial mechanisms promoting weight loss and improved metabolism following Roux-en-Y gastric bypass (GB) surgery remain incompletely understood. Recent rodent studies suggest that bile acids can mediate energy homeostasis by activating the G-protein coupled receptor TGR5 and the type 2 thyroid hormone deiodinase. Altered gastrointestinal anatomy following GB could affect enterohepatic recirculation of bile acids. We assessed whether circulating bile acid concentrations differ in patients who previously underwent GB, which might then contribute to improved metabolic homeostasis. We performed cross-sectional analysis of fasting serum bile acid composition and both fasting and post-meal metabolic variables, in three subject groups: (i) post-GB surgery (n = 9), (ii) without GB matched to preoperative BMI of the index cohort (n = 5), and (iii) without GB matched to current BMI of the index cohort (n = 10). Total serum bile acid concentrations were higher in GB (8.90 +/- 4.84 micromol/l) than in both overweight (3.59 +/- 1.95, P = 0.005, Ov) and severely obese (3.86 +/- 1.51, P = 0.045, MOb). Bile acid subfractions taurochenodeoxycholic, taurodeoxycholic, glycocholic, glycochenodeoxycholic, and glycodeoxycholic acids were all significantly higher in GB compared to Ov (P < 0.05). Total bile acids were inversely correlated with 2-h post-meal glucose (r = -0.59, P < 0.003) and fasting triglycerides (r = -0.40, P = 0.05), and positively correlated with adiponectin (r = -0.48, P < 0.02) and peak glucagon-like peptide-1 (GLP-1) (r = 0.58, P < 0.003). Total bile acids strongly correlated inversely with thyrotropic hormone (TSH) (r = -0.57, P = 0.004). Together, our data suggest that altered bile acid levels and composition may contribute to improved glucose and lipid metabolism in patients who have had GB.

AB - The multifactorial mechanisms promoting weight loss and improved metabolism following Roux-en-Y gastric bypass (GB) surgery remain incompletely understood. Recent rodent studies suggest that bile acids can mediate energy homeostasis by activating the G-protein coupled receptor TGR5 and the type 2 thyroid hormone deiodinase. Altered gastrointestinal anatomy following GB could affect enterohepatic recirculation of bile acids. We assessed whether circulating bile acid concentrations differ in patients who previously underwent GB, which might then contribute to improved metabolic homeostasis. We performed cross-sectional analysis of fasting serum bile acid composition and both fasting and post-meal metabolic variables, in three subject groups: (i) post-GB surgery (n = 9), (ii) without GB matched to preoperative BMI of the index cohort (n = 5), and (iii) without GB matched to current BMI of the index cohort (n = 10). Total serum bile acid concentrations were higher in GB (8.90 +/- 4.84 micromol/l) than in both overweight (3.59 +/- 1.95, P = 0.005, Ov) and severely obese (3.86 +/- 1.51, P = 0.045, MOb). Bile acid subfractions taurochenodeoxycholic, taurodeoxycholic, glycocholic, glycochenodeoxycholic, and glycodeoxycholic acids were all significantly higher in GB compared to Ov (P < 0.05). Total bile acids were inversely correlated with 2-h post-meal glucose (r = -0.59, P < 0.003) and fasting triglycerides (r = -0.40, P = 0.05), and positively correlated with adiponectin (r = -0.48, P < 0.02) and peak glucagon-like peptide-1 (GLP-1) (r = 0.58, P < 0.003). Total bile acids strongly correlated inversely with thyrotropic hormone (TSH) (r = -0.57, P = 0.004). Together, our data suggest that altered bile acid levels and composition may contribute to improved glucose and lipid metabolism in patients who have had GB.

U2 - 10.1038/oby.2009.102

DO - 10.1038/oby.2009.102

M3 - Journal article

C2 - 19360006

SN - 1930-7381

VL - 17

SP - 1671

EP - 1677

JO - Obesity

JF - Obesity

IS - 9

ER -

Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism

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