Altered bile acid kinetics contribute to postprandial hypoglycaemia after Roux-en-Y gastric bypass surgery
| العنوان: | Altered bile acid kinetics contribute to postprandial hypoglycaemia after Roux-en-Y gastric bypass surgery |
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| المؤلفون: | Fianne L. P. Sips, Albert K. Groen, Jan F de Boer, Merel van den Broek, Marloes Emous, Martijn van Faassen, Natal A. W. van Riel, Folkert Kuipers, Loek J M de Heide, André P van Beek, Martijn Koehorst, Tim van Zutphen |
| المساهمون: | Computational Biology, Eindhoven MedTech Innovation Center, EAISI Health, Experimental Vascular Medicine, Vascular Medicine, ACS - Diabetes & metabolism, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ACS - Microcirculation, ACS - Atherosclerosis & ischemic syndromes, Health & Food, Lifestyle Medicine (LM), Center for Liver, Digestive and Metabolic Diseases (CLDM) |
| المصدر: | International Journal of Obesity, 45(3), 619-630. Nature Publishing Group International journal of obesity (2005), 45(3), 619-630. Nature Publishing Group Int J Obes (Lond) |
| بيانات النشر: | Nature Publishing Group, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, medicine.drug_class, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Gastric Bypass, Medicine (miscellaneous), 030209 endocrinology & metabolism, SDG 3 – Goede gezondheid en welzijn, medicine.disease_cause, Article, Bile Acids and Salts, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Ingestion, Humans, 030212 general & internal medicine, Obesity, Nutrition and Dietetics, Bile acid, Gastric bypass surgery, business.industry, Insulin, nutritional and metabolic diseases, FGF19, Middle Aged, Postprandial Period, G protein-coupled bile acid receptor, Hypoglycemia, Kinetics, Endocrinology, Postprandial, Basal (medicine), Case-Control Studies, Female, business |
| الوصف: | BACKGROUND/OBJECTIVES: Bile acids (BA) act as detergents in intestinal fat absorption and as modulators of metabolic processes via activation of receptors such as FXR and TGR5. Elevated plasma BA as well as increased intestinal BA signalling to promote GLP-1 release have been implicated in beneficial health effects of Roux-en-Y gastric bypass surgery (RYGB). Whether BA also contribute to the postprandial hypoglycaemia that is frequently observed post-RYGB is unknown.METHODS: Plasma BA, fibroblast growth factor 19 (FGF19), 7α-hydroxy-4-cholesten-3-one (C4), GLP-1, insulin and glucose levels were determined during 3.5 h mixed-meal tolerance tests (MMTT) in subjects after RYGB, either with (RYGB, n = 11) or without a functioning gallbladder due to cholecystectomy (RYGB-CC, n = 11). Basal values were compared to those of age, BMI and sex-matched obese controls without RYGB (n = 22).RESULTS: Fasting BA as well as FGF19 levels were elevated in RYGB and RYGB-CC subjects compared to non-bariatric controls, without significant differences between RYGB and RYGB-CC. Postprandial hypoglycaemia was observed in 8/11 RYGB-CC and only in 3/11 RYGB. Subjects who developed hypoglycaemia showed higher postprandial BA levels coinciding with augmented GLP-1 and insulin responses during the MMTT. The nadir of plasma glucose concentrations after meals showed a negative relationship with postprandial BA peaks. Plasma C4 was lower during MMTT in subjects experiencing hypoglycaemia, indicating lower hepatic BA synthesis. Computer simulations revealed that altered intestinal transit underlies the occurrence of exaggerated postprandial BA responses in hypoglycaemic subjects.CONCLUSION: Altered BA kinetics upon ingestion of a meal, as frequently observed in RYGB-CC subjects, appear to contribute to postprandial hypoglycaemia by stimulating intestinal GLP-1 release. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1476-5497 0307-0565 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c071a1066192c98bd23f4226f3c0c4fc https://doi.org/10.1038/s41366-020-00726-w |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....c071a1066192c98bd23f4226f3c0c4fc |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14765497 03070565 |
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