Skip header and navigation

2 records – page 1 of 1.

Conjugated bile acids associate with altered rates of glucose and lipid oxidation after Roux-en-Y gastric bypass.

https://arctichealth.org/en/permalink/ahliterature124015
Source
Obes Surg. 2012 Sep;22(9):1473-80
Publication Type
Article
Date
Sep-2012
Author
M. Simonen
N. Dali-Youcef
D. Kaminska
S. Venesmaa
P. Käkelä
M. Pääkkönen
M. Hallikainen
M. Kolehmainen
M. Uusitupa
L. Moilanen
M. Laakso
H. Gylling
M E Patti
J. Auwerx
Jussi Pihlajamäki
Author Affiliation
Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
Source
Obes Surg. 2012 Sep;22(9):1473-80
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adipose Tissue - metabolism
Bile Acids and Salts - blood
Biological Markers - blood
Blood Glucose - metabolism
Body mass index
Energy Metabolism
Female
Finland
Gastric Bypass
Glucose - metabolism
Humans
Lipid Metabolism
Liver - metabolism
Longitudinal Studies
Male
Middle Aged
Obesity, Morbid - blood - surgery
Treatment Outcome
Abstract
Laparoscopic Roux-en-Y gastric bypass (RYGB) induces a more favorable metabolic profile than expected by weight loss alone. In this study, we investigated the effect of RYGB on serum bile acid levels and their relation to clinical outcomes.
We included 30 obese patients who underwent RYGB (BMI?=?46.1?±?5.9 kg/m(2)). Clinical measurements and laboratory determinations were performed before surgery and 1 year after surgery. Fasting serum bile acids were measured by an enzymatic method and individual bile acids were quantified by HLPC-tandem mass spectrometry. Indirect calorimetry was performed to measure the rates of energy expenditure and substrate oxidation.
Fasting total serum bile acid levels increased twofold after RYGB (pre, 3.68?±?2.03 vs. post, 7.06?±?9.65 µmol/l, +92 %, p?=?0.002). This increase in total bile acids was accompanied by a decrease in conjugated bile acids, which correlated with decreased glucose oxidation (r?=?0.571, p?=?0.002) and with increased lipid oxidation (r?=?-0.626, p?=?0.0004). The change in taurine-conjugated bile acids correlated with altered DIO2 mRNA expression in adipose tissue (r?=?-0.498, p?=?0.013) potentially linking bile acid conjugation to substrate oxidation through DIO2.
Fasting serum bile acid levels increase after RYGB. More specifically, changes in bile acid conjugation after RYGB associate with altered energy metabolism.
PubMed ID
22638681 View in PubMed
Less detail

Hypoglycaemia following gastric bypass surgery-diabetes remission in the extreme?

https://arctichealth.org/en/permalink/ahliterature99171
Source
Diabetologia. 2010 Aug 21;
Publication Type
Article
Date
Aug-21-2010
Author
M E Patti
A B Goldfine
Author Affiliation
Research Division, Joslin Diabetes Center and Harvard Medical School, 1 Joslin Place, Boston, MA, 02215, USA, mary.elizabeth.patti@joslin.harvard.edu.
Source
Diabetologia. 2010 Aug 21;
Date
Aug-21-2010
Language
English
Publication Type
Article
Abstract
Postprandial hypoglycaemia is increasingly recognised as a complication of gastric bypass surgery. While post-bypass hypoglycaemia is often responsive to dietary modification, a subset of individuals develop life-threatening neuroglycopenia, with loss of consciousness, seizures and motor vehicle accidents. Such patients require complex nutritional and medical management strategies to reduce postprandial insulin secretion and stabilise glucose excursions, using medications including acarbose, octreotide and diazoxide, and frequent monitoring of glucose values. In an article in this issue of Diabetologia, nationwide registry data from Sweden were used to assess the frequency of severe hypoglycaemia and potentially related diagnoses (e.g. confusion, syncope, seizures, accidental death) following obesity surgery. Relative risk of hypoglycaemia and related diagnoses were two- to sevenfold higher in the post-gastric bypass population, but absolute risk was small. While these data underscore that hypoglycaemia is an important complication of gastric bypass, many questions regarding frequency, pathogenesis and optimal therapy remain unanswered. Given that hypoglycaemia is usually evaluated in the outpatient setting, more precise assessments of hypoglycaemia frequency will require prospective longitudinal studies in post-bypass cohorts. Until such data are available, practitioners should have a higher awareness of symptoms consistent with neuroglycopenia in patients with a history of bariatric surgery. Understanding the beneficial and challenging metabolic consequences of bariatric surgery is a key imperative for the diabetes community, as such data may yield novel insights into mechanisms by which bariatric surgery can lead to diabetes remission.
PubMed ID
20730413 View in PubMed
Less detail