Yang John Zhiyong, Li Michelle, Zhou Weiyu, Nemati Reza, Jin Xiaodong, Plank Lindsay D, Murphy Rinki, Lu Jun
Quzhou Eco-Industrial Innovation Institute, Zhejiang University of Technology Hangzhou, Zhejiang, China.
Department of Food and Agriculture Technology, Yangtze Delta Region Institute of Tsinghua University, Jiaxing, China.
Obesity (Silver Spring). 2025 Jul;33(7):1275-1286. doi: 10.1002/oby.24308. Epub 2025 Jun 15.
This study aimed to explore the dynamic role of bile acids (BAs) in metabolic improvements following bariatric surgery, specifically comparing the effects of silastic ring laparoscopic Roux-en-Y gastric bypass (SR-LRYGB) and laparoscopic sleeve gastrectomy (LSG) on BA composition and clinical parameters over a 5-year period.
A cohort of patients with obesity and type 2 diabetes underwent SR-LRYGB or LSG. Principal component analysis was performed to evaluate BAs and clinical outcomes.
Despite significant increases in the first year after surgery, BA levels returned to baseline after 5 years. However, principal component analysis revealed that certain BA profiles may contribute to long-term metabolic benefits.
Although total BA levels return to baseline by 5 years after surgery, specific BA profiles, as identified by principal component analysis from oral glucose tolerance test data, are associated with sustained metabolic improvements. SR-LRYGB is associated with more durable metabolic benefits compared with LSG. However, given the use of the oral glucose tolerance test, which may not fully capture postprandial BA dynamics, further research using mixed-meal tolerance tests is needed to confirm these findings.
本研究旨在探讨胆汁酸（BAs）在减肥手术后代谢改善中的动态作用，特别是比较硅胶环腹腔镜Roux-en-Y胃旁路术（SR-LRYGB）和腹腔镜袖状胃切除术（LSG）在5年期间对BA组成和临床参数的影响。
一组肥胖和2型糖尿病患者接受了SR-LRYGB或LSG手术。进行主成分分析以评估BAs和临床结果。
尽管术后第一年BA水平显著升高，但5年后BA水平恢复到基线。然而，主成分分析显示，某些BA谱可能有助于长期代谢益处。
虽然术后5年总BA水平恢复到基线，但通过口服葡萄糖耐量试验数据的主成分分析确定的特定BA谱与持续的代谢改善相关。与LSG相比，SR-LRYGB与更持久的代谢益处相关。然而，鉴于使用了口服葡萄糖耐量试验，其可能无法完全捕捉餐后BA动态，需要使用混合餐耐量试验进行进一步研究以证实这些发现。
