Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, 1 Debinki, 80-211, Gdansk, Poland.
Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, 63 Wita Stwosza, 80-308, Gdansk, Poland.
Obes Surg. 2018 Nov;28(11):3405-3414. doi: 10.1007/s11695-018-3314-9.
Bariatric surgery contributes to the improvement in glucose metabolism that may be related to a postoperative increase in serum bile acids (BAs). Three commonly used types of bariatric procedures, laparoscopic sleeve gastrectomy (LSG) (without creation of a bile loop), Roux-en-Y gastric bypass (RYGB), and omega-loop gastric bypass (OLGB) (with creation of shorter 100-150 cm and longer 200-280 cm bile loops, respectively), differ in their effects on glycemic control. The aim of the study was to compare the effects of various bariatric procedures on serum BA concentration and glucose homeostasis.
Serum BAs in 26 obese patients were determined by liquid chromatography-mass spectrometry prior to bariatric surgery, as well as 4 days and 3 months thereafter.
Four days after the surgery, serum concentrations of BAs in LSG and OLGB groups were similar as prior to the procedure, and a slight decrease in serum BAs was observed in the RYGB group. Serum BA level in the LSG group remained unchanged also at 3 months after the surgery, whereas a significant 0.5- and 3-fold increase in this parameter was noted in the RYGB and OLGB groups, respectively. Serum concentration of BAs correlated positively with the length of the bile loop (R = 0.47, p < 0.05).
The evident improvement of glycemic control observed 3 months after OLGB might be associated with a postoperative increase in serum BAs, resulting from their better absorption from the longer bile loop. However, the changes in serum BAs probably had little or no impact on insulin sensitivity improvement at 4 days post-surgery.
减重手术有助于改善葡萄糖代谢，这可能与术后血清胆汁酸（BAs）水平升高有关。三种常用的减重手术方式，腹腔镜袖状胃切除术（LSG）（不形成胆肠回路）、Roux-en-Y 胃旁路术（RYGB）和 omega 环胃旁路术（OLGB）（分别形成较短的 100-150cm 和较长的 200-280cm 胆肠回路），对血糖控制的影响不同。本研究旨在比较各种减重手术对血清 BA 浓度和葡萄糖稳态的影响。
在减重手术前，通过液相色谱-质谱法测定 26 例肥胖患者的血清 BA，术后 4 天和 3 个月后再次测定。
LSG 和 OLGB 组术后 4 天血清 BA 浓度与术前相似，RYGB 组血清 BA 浓度略有下降。LSG 组术后 3 个月血清 BA 水平仍无变化，而 RYGB 和 OLGB 组分别观察到该参数 0.5-和 3 倍的显著增加。血清 BA 浓度与胆肠回路长度呈正相关（R=0.47，p<0.05）。
OLGB 术后 3 个月血糖控制明显改善，可能与术后血清 BAs 增加有关，这可能是由于较长的胆肠回路更好地吸收了 BAs。然而，术后 4 天血清 BAs 的变化可能对胰岛素敏感性的改善影响不大或没有影响。
