50 Sleeve Gastrectomy in Obese Mice Results in Elevated Serum Bile Acids and Reduced Hepatic Steatosis That Correlate With Weight Loss Post Surgery

AbstractVertical sleeve gastrectomy (VSG) is one of the most commonly performed clinical bariatric surgeries for the remission of obesity and diabetes. Its effects include weight loss, improved insulin resistance, and the improvement of hepatic steatosis. Epidemiologic studies demonstrated that vitamin D deficiency (VDD) is associated with many diseases, including obesity. To explore the role of vitamin D in metabolic disorders for patients with obesity after VSG. We established a murine model of diet-induced obesity + VDD, and we performed VSGs to investigate VDD's effects on the improvement of metabolic disorders present in post-VSG obese mice. We observed that in HFD mice, the concentration of VitD3 is four fold of HFD + VDD one. In the post-VSG obese mice, VDD attenuated the improvements of hepatic steatosis, insulin resistance, intestinal inflammation and permeability, the maintenance of weight loss, the reduction of fat loss, and the restoration of intestinal flora that were weakened. Our results suggest that in post-VSG obese mice, maintaining a normal level of vitamin D plays an important role in maintaining the improvement of metabolic disorders.

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479 Elevated Serum Bile Acids Contribute to the Neurological Impairment Following Acute Liver Failure

Gastroenterology ◽

10.1016/s0016-5085(14)63324-2 ◽

2014 ◽

Vol 146 (5) ◽

pp. S-914-S-915 ◽

Cited By ~ 1

Author(s):

Samir Ashfaq ◽

Matthew McMillin ◽

Cheryl Galindo ◽

Gabriel A. Frampton ◽

Sharon DeMorrow

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Bile Acids ◽

Elevated Serum ◽

Neurological Impairment ◽

Serum Bile Acids

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Hepatic Steatosis Is Associated with Elevated Serum Iron in Patients with Obesity and Improves after Laparoscopic Sleeve Gastrectomy

Obesity Facts ◽

10.1159/000511736 ◽

2020 ◽

pp. 1-8

Author(s):

Bingwei Ma ◽

Hang Sun ◽

Bing Zhu ◽

Shilin Wang ◽

Lei Du ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Hepatic Steatosis ◽

Elevated Serum ◽

Density Lipoprotein ◽

Postprandial Blood Glucose ◽

Iron Level ◽

Metabolic Markers ◽

Alcoholic Fatty Liver ◽

Negatively Associated

Background: Iron is closely related to metabolism. However, the relationship between iron and hepatic steatosis has not been fully elucidated. Objective: We aimed to investigate the triangular relationship between iron and hepatic steatosis and laparoscopic sleeve gastrectomy (LSG) in patients with obesity. Methods: A total of 297 patients with obesity and 43 healthy individuals with a normal BMI were enrolled. Eighty-two patients underwent LSG. Anthropometrics, glucose-lipid metabolic markers, and hepatic steatosis assessed by FibroScan (CAP value and E value) were measured at baseline, and again at follow-up time intervals of 6 months and 1 year after surgery. Results: (1) Iron was significantly higher in patients with obesity or overweight than in the individuals with normal BMI (8.18 ± 1.47 vs. 7.46 ± 0.99 mmol/L, p = 0.002). Iron was also higher in subjects with high blood pressure, dyslipidemia, and hyperuricemia than non-corresponding disorders (all p < 0.05). Moreover, iron was significantly higher in the severe than mild or moderate non-alcoholic fatty liver disease (NAFLD) group (p = 0.046 and 0.018). (2) Iron was positively associated with body weight, BMI, waist-to-hip ratio, uric acid, liver enzymes, postprandial blood glucose, fasting insulin, HOMA-IR, triglycerides, free fatty acid, and hepatic steatosis (CAP value), and negatively associated with high-density lipoprotein cholesterol (all p < 0.05). Iron was also positively associated with the visceral adipose area in patients with obesity and negatively associated with the subcutaneous adipose area in patients with overweight (all p < 0.05). (3) Iron levels and CAP values were decreased gradually 6 months and 1 year after surgery (all p < 0.05). Conclusions: Overall, our results indicated that iron is associated with hepatic steatosis in obesity. The iron level was significantly higher in patients with severe NAFLD than with mild or moderate NAFLD. LSG may reduce iron levels while improving fat deposition in the liver.

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Altered drug metabolism and elevated serum bile acids in liver disease: A unified pharmacokinetic explanation

Gastroenterology ◽

10.1016/0016-5085(80)90211-5 ◽

1980 ◽

Vol 78 (1) ◽

pp. 177-179 ◽

Cited By ~ 30

Author(s):

Ian T. Gilmore ◽

Alan F. Hofmann

Keyword(s):

Liver Disease ◽

Drug Metabolism ◽

Bile Acids ◽

Elevated Serum ◽

Serum Bile Acids

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Sleeve Gastrectomy Suppresses Hepatic Glucose Production and Increases Hepatic Insulin Clearance Independent of Weight-Loss

10.2337/figshare.15070008 ◽

2021 ◽

Author(s):

Rachel Ben-Haroush Schyr ◽

Abbas Al-Kurd ◽

Botros Moalem ◽

Anna Permyakova ◽

Hadar Israeli ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Hepatic Steatosis ◽

Hepatic Glucose Production ◽

Glucose Production ◽

Insulin Clearance ◽

Insulin Metabolism ◽

Insulin Levels ◽

Hepatic Glucose ◽

Hepatic Insulin Clearance

Bariatric surgeries induce weight loss which is associated with an improvement in hepatic steatosis and reduction in hepatic glucose production. It is not clear whether these outcomes are entirely due to weight-loss, or whether the new anatomy imposed by the surgery contributes to the improvement in the metabolic function of the liver. We performed vertical sleeve gastrectomy (VSG) on obese mice provided with a high-fat high-sucrose diet, and compared them to diet and weight-matched sham-operated mice (WMS). 40 days after surgery, VSG-operated mice displayed lesser hepatic steatosis compared to WMS. By measuring the fasting glucose and insulin levels in the blood vessels feeding and draining the liver we showed directly that hepatic glucose production was suppressed after VSG. Insulin levels were elevated in the portal vein, and hepatic insulin clearance was elevated in VSG-operated mice. The hepatic expression of genes associated with insulin clearance was upregulated. We repeated the experiment in lean mice and observed that portal insulin and glucagon are elevated, but only insulin clearance is increased in VSG-operated mice. In conclusion, direct measurement of glucose and insulin in the blood entering and leaving the liver shows that VSG affects glucose and insulin metabolism through weight-loss and diet-independent mechanisms.

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Sleeve Gastrectomy Suppresses Hepatic Glucose Production and Increases Hepatic Insulin Clearance Independent of Weight-Loss

10.2337/figshare.15070008.v1 ◽

2021 ◽

Author(s):

Rachel Ben-Haroush Schyr ◽

Abbas Al-Kurd ◽

Botros Moalem ◽

Anna Permyakova ◽

Hadar Israeli ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Hepatic Steatosis ◽

Hepatic Glucose Production ◽

Glucose Production ◽

Insulin Clearance ◽

Insulin Metabolism ◽

Insulin Levels ◽

Hepatic Glucose ◽

Hepatic Insulin Clearance

Bariatric surgeries induce weight loss which is associated with an improvement in hepatic steatosis and reduction in hepatic glucose production. It is not clear whether these outcomes are entirely due to weight-loss, or whether the new anatomy imposed by the surgery contributes to the improvement in the metabolic function of the liver. We performed vertical sleeve gastrectomy (VSG) on obese mice provided with a high-fat high-sucrose diet, and compared them to diet and weight-matched sham-operated mice (WMS). 40 days after surgery, VSG-operated mice displayed lesser hepatic steatosis compared to WMS. By measuring the fasting glucose and insulin levels in the blood vessels feeding and draining the liver we showed directly that hepatic glucose production was suppressed after VSG. Insulin levels were elevated in the portal vein, and hepatic insulin clearance was elevated in VSG-operated mice. The hepatic expression of genes associated with insulin clearance was upregulated. We repeated the experiment in lean mice and observed that portal insulin and glucagon are elevated, but only insulin clearance is increased in VSG-operated mice. In conclusion, direct measurement of glucose and insulin in the blood entering and leaving the liver shows that VSG affects glucose and insulin metabolism through weight-loss and diet-independent mechanisms.

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Serum bile acids and GLP-1 decrease following telemetric induced weight loss: results of a randomized controlled trial

Scientific Reports ◽

10.1038/srep30173 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 9

Author(s):

Ronald Biemann ◽

Marina Penner ◽

Katrin Borucki ◽

Sabine Westphal ◽

Claus Luley ◽

...

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Bile Acids ◽

Controlled Trial ◽

Serum Bile Acids ◽

Randomized Controlled

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Early changes in immune cell count, metabolism, and function following sleeve gastrectomy: a prospective human study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab673 ◽

2021 ◽

Author(s):

Tammy Lo ◽

Renuka S Haridas ◽

Eleanor J M Rudge ◽

Robert P Chase ◽

Keyvan Heshmati ◽

...

Keyword(s):

Gene Expression ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Whole Blood ◽

Immune Cell ◽

Human Study ◽

Body Weight Loss ◽

Blood Biomarkers ◽

Neutrophil Lymphocyte Ratio ◽

Post Surgery

Abstract Objective To characterize longitudinal changes in blood biomarkers, leukocyte composition, and gene expression following laparoscopic sleeve gastrectomy (LSG). Background LSG is an effective treatment for obesity, leading to sustainable weight loss and improvements in obesity-related co-morbidities and inflammatory profiles. However, the effects of LSG on immune function and metabolism remain uncertain. Methods Prospective data was collected from 23 enrolled human subjects from a single institution. Parameters of weight, co-morbidities, and trends in blood biomarkers and leukocyte subsets were observed from pre-operative baseline to one year in three-month follow-up intervals. RNA-sequencing was performed on pairs of whole blood samples from the first six subjects of the study (baseline and three months post-surgery) to identify genome-wide gene expression changes associated with undergoing LSG. Results LSG led to a significant decrease in mean total body weight loss (18.1%) at three months and among diabetic subjects a reduction in HbA1c. Improvements in clinical inflammatory and hormonal biomarkers were demonstrated as early as three months after LSG. A reduction in neutrophil-lymphocyte ratio was observed, driven by a reduction in absolute neutrophil counts. Gene set enrichment analyses of differential whole blood gene expression demonstrated that after three months, LSG induced transcriptomic changes not only in inflammatory cytokine pathways but also in several key metabolic pathways related to energy metabolism. Conclusions LSG induces significant changes in the composition and metabolism of immune cells as early as three months post-operatively. Further evaluation is required of bariatric surgery’s effects on immunometabolism and consequences for host defense and metabolic disease.

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