Increased Bile Acid Synthesis and Deconjugation After Biliopancreatic Diversion

• DOI: 10.2337/db15-0214
• Publication Date: 2015-05-27T16:36:22Z
• Authors: Ele Ferrannini; Stefania Camastra; Brenno Astiarraga; Monica Nannipieri; Jose Castro-Perez; Dan Xie; Liangsu Wang; Manu Chakravarthy; Rebecca A. Haeusler
• Keywords: Enterohepatic circulation; Biliopancreatic Diversion; FGF19

Biliopancreatic diversion (BPD) improves insulin sensitivity and decreases serum cholesterol out of proportion with weight loss. Mechanisms these effects are unknown. One set proposed contributors to metabolic improvements after bariatric surgeries is bile acids (BAs). We investigated the early late BPD on plasma BA levels, composition, markers synthesis in 15 patients type 2 diabetes (T2D). compared Roux-en-Y gastric bypass (RYGB) 22 T2D 16 normal glucose tolerance. Seven weeks BPD, had doubled halved. At this time, total BAs, particularly unconjugated markedly risen; effect could not be entirely explained by low FGF19. In contrast, RYGB, improved gradually loss levels declined marginally; were decreased at an time point (2 weeks) surgery returned range 1 year later. These findings indicate that contributes BPD. Moreover, they suggest a potential role for altered enterohepatic circulation BAs improving metabolism