Wang Wenting, Cheng Zhiqiang, Wang Yanlei, Dai Yong, Zhang Xiang, Hu Sanyuan
Department of Obstetrics and Gynecology, The Second Hospital of Shandong University, Jinan, China.
Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
Front Physiol. 2019 Apr 2;10:374. doi: 10.3389/fphys.2019.00374. eCollection 2019.
Bariatric surgery has been proved to be effective and sustainable in the long-term weight-loss and remission of metabolic disorders. However, the underlying mechanisms are still far from fully elucidated. After bariatric surgery, the gastrointestinal tract is manipulated, either anatomically or functionally, leading to changed bile acid metabolism. Accumulating evidence has shown that bile acids play a role in metabolic regulation as signaling molecules other than digestive juice. And most of the metabolism-beneficial effects are mediated through nuclear receptor FXR and membrane receptor TGR5, as well as reciprocal influence on gut microbiota. Bile diversion procedure is also performed on animals to recapitulate the benefits of bariatric surgery. It appears that bile acid alteration is an important component of bariatric surgery, and represents a promising target for the management of metabolic disorders.
减肥手术已被证明在长期减重和缓解代谢紊乱方面是有效且可持续的。然而,其潜在机制仍远未完全阐明。减肥手术后,胃肠道在解剖结构或功能上受到操控,导致胆汁酸代谢发生变化。越来越多的证据表明,胆汁酸作为信号分子而非消化液在代谢调节中发挥作用。并且大多数有益代谢的作用是通过核受体FXR和膜受体TGR5介导的,以及对肠道微生物群的相互影响。还对动物进行胆汁转流手术以重现减肥手术的益处。胆汁酸改变似乎是减肥手术的一个重要组成部分,并且是治疗代谢紊乱的一个有前景的靶点。