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Obesity Surgery
Published in: Obesity Surgery 6/2016

01-06-2016 | Original Contributions

Changes in Bile Acid Profile After Laparoscopic Sleeve Gastrectomy are Associated with Improvements in Metabolic Profile and Fatty Liver Disease

Authors: Ajay P. Belgaumkar, Royce P. Vincent, Kirstin A. Carswell, Robin D. Hughes, Jamie Alaghband-Zadeh, Ragai R. Mitry, Carel W. le Roux, Ameet G. Patel

Published in: Obesity Surgery | Issue 6/2016

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Abstract

Background

Bile acids (BA) modulate lipid and glucose metabolism in a feedback loop through production of fibroblast growth factor (FGF) 19 in the terminal ileum. Changes in BA after bariatric surgery may lead to improvements in the metabolic syndrome, including fatty liver disease. This study investigated the relationship between BA and metabolic and inflammatory profiles after laparoscopic sleeve gastrectomy (LSG).

Methods

Patients undergoing LSG had fasting blood samples taken pre-operatively and 6 months post-surgery. Liver injury was measured using cytokeratin (CK) 18 fragments. BA were measured using liquid chromatography tandem-mass spectrometry. FGF-19 was measured using enzyme-linked immunosorbent assay.

Results

The study included 18 patients (12 females), with mean age 46.3 years (SEM ± 2.9) and BMI 60.1 kg/m2 (±2.6). After 6 months, patients lost 39.8 kg (±3.1; p < 0.001). Fourteen patients (78 %) had steatosis. FGF-19 increased from median 128.1 (IQR 89.4–210.1) to 177.1 (121.8–288.9, p = 0.045) at 6 months. Although total BA did not change, primary glycine- and taurine-conjugated BA, cholic acid decreased, and secondary BA, glycine-conjugated urodeoxycholic acid increased over the study period. These changes are associated with reduction in insulin resistance, pro-inflammatory cytokines and CK-18 levels.

Conclusions

The profile of individual BA is altered after LSG. These changes occur in the presence of reductions in inflammatory cytokines and markers of liver injury. This study supports evidence from recent animal models that LSG may have an effect on fatty liver through changes in BA metabolism.
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Metadata
Title
Changes in Bile Acid Profile After Laparoscopic Sleeve Gastrectomy are Associated with Improvements in Metabolic Profile and Fatty Liver Disease
Authors
Ajay P. Belgaumkar
Royce P. Vincent
Kirstin A. Carswell
Robin D. Hughes
Jamie Alaghband-Zadeh
Ragai R. Mitry
Carel W. le Roux
Ameet G. Patel
Publication date
01-06-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1878-1

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