So Stephanie Sik Yu, Yeung Chris Ho Ching, Schooling C Mary, El-Nezami Hani
School of Biological Sciences, Faculty of Science, Kadoorie Biological Sciences Building, The University of Hong Kong, Pokfulam, Hong Kong.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Obes Rev. 2020 Jul;21(7):e13017. doi: 10.1111/obr.13017. Epub 2020 Mar 18.
A systematic review and meta-analysis was conducted of studies that address the association of bile acid (BA) with obesity and of studies on the effects of treatment in patients with obesity on BA metabolism, assessed from systemic BA, fibroblast growth factor 19 (FGF19), 7α-hydroxy-4-cholesten-3-one (C4) level, and faecal BA. We searched PubMed, Embase, and the Cochrane Library from inception to 1 August 2019 using the keywords obesity, obese, body mass index, and overweight with bile acid, FGF19, FXR, and TGR5. Two reviewers independently searched, selected, and assessed the quality of studies. Data were analysed using either fixed or random effect models with inverse variance weighting. Of 3771 articles, 33 papers were relevant for the association of BA with obesity of which 22 were included in the meta-analysis, and 50 papers were relevant for the effect of obesity interventions on BA of which 20 were included in the meta-analysis. Circulating fasting total BA was not associated with obesity. FGF19 was inversely and faecal BA excretion was positively associated with obesity. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) modulated BA metabolism, ie, increased BA and FGF19. Our results indicate that BA metabolism is altered in obesity. Certain bariatric surgeries including RYGB and SG modulate BA, whether these underlie the beneficial effect of the treatment should be investigated.
我们对有关胆汁酸（BA）与肥胖症关联的研究以及肥胖症患者治疗对BA代谢影响的研究进行了系统评价和荟萃分析，这些影响通过全身BA、成纤维细胞生长因子19（FGF19）、7α-羟基-4-胆甾烯-3-酮（C4）水平和粪便BA进行评估。我们使用关键词肥胖症、肥胖、体重指数、超重以及胆汁酸、FGF19、法尼醇X受体（FXR）和G蛋白偶联受体5（TGR5），在PubMed、Embase和Cochrane图书馆中从创刊至2019年8月1日进行检索。两名评审员独立检索、筛选并评估研究质量。使用固定效应模型或随机效应模型并采用逆方差加权法对数据进行分析。在3771篇文章中，33篇与BA和肥胖症的关联相关，其中22篇纳入荟萃分析；50篇与肥胖症干预对BA的影响相关，其中20篇纳入荟萃分析。空腹循环总BA与肥胖症无关。FGF19与肥胖症呈负相关，粪便BA排泄与肥胖症呈正相关。Roux-en-Y胃旁路术（RYGB）和袖状胃切除术（SG）可调节BA代谢，即增加BA和FGF19。我们的结果表明，肥胖症中BA代谢发生改变。包括RYGB和SG在内的某些减肥手术可调节BA，是否这些是治疗有益效果的基础有待研究。
