scholarly journals Bile acid, glucose, lipid profile, and liver enzyme changes in pre-diabetics after sleeve gastrectomy

2020 ◽  
Author(s):  
Tsz Kin Mak ◽  
Shifang Huang ◽  
Bingsheng Guan ◽  
Hoyin Au ◽  
Tsz Hong Chong ◽  
...  

Abstract BackgroundFew articles have studied pre-diabetes after sleeve gastrectomy. Bile acid, and lipid metabolism remains inconsistent in post-bariatric patients. ObjectiveTo explore bile acid and glucose, lipid, and liver enzyme changes in different diabetic status underwent sleeve gastrectomy. To discuss the impact of bariatric surgery and its potential benefits to pre-diabeticsMethods202 overweight and obese patients underwent bariatric surgery between January 2016 and October 2018 in our hospital were retrospectively reviewed. They were divided into Pre-diabetes (n=32), Non-diabetes (n=144), and Diabetes (n=26) and analyzed respectively. Data of glucose and lipid metabolism were collected from medical records from baseline and each follow-up visit.ResultSignificant improvement in body weight, glucose and lipid metabolism, and liver enzyme at P≤0.05 in prediabetics were found throughout first year post-op. Improvement of glycemic control was first seen in a month post op, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, associated with ALT improvement, in pre-diabetes 1-year post-surgery. There was no significant differences in HbA1c, glucose, and triglycerides (TG) between Pre-diabetics and T2DM nor between prediabetics and non-diabetics at 12 months post-surgery.ConclusionLSG is highly effective in interfering glucose and lipid metabolism as well as total bile acid of prediabetics in the first year post op. Thus, LSG is indeed an alternative for overweight and obese prediabetics

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsz Kin Mak ◽  
Shifang Huang ◽  
Bingsheng Guan ◽  
Hoyin Au ◽  
Tsz Hong Chong ◽  
...  

Abstract Background Few articles have studied individuals with prediabetes after sleeve gastrectomy. Bile acid and lipid levels remain inconsistent in postbariatric patients. The purpose of this study was to explore bile acid, glucose, lipid, and liver enzyme changes in patients with different diabetes statuses who underwent sleeve gastrectomy. The impact of bariatric surgery and its potential benefits for prediabetic patients was also discussed. Methods A total of 202 overweight and obese patients who underwent bariatric surgery in our hospital between January 2016 and October 2018 were retrospectively reviewed. Patients were divided into prediabetes (n = 32), nondiabetes (n = 144), and diabetes (n = 26) groups and analysed. Glucose and lipid data were collected from medical records at baseline and at each follow-up visit. Result Significant improvements in body weight, glucose and lipid levels, and liver enzymes (P ≤ 0.05) in prediabetic patients were found throughout the first year postoperatively. Improvement in glycaemic control was first seen one month postoperatively, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, which was associated with ALT improvement in prediabetic patients 1-year post-surgery. There were no significant differences in HbA1c, glucose, or triglycerides (TGs) between prediabetic and T2DM patients or between prediabetic and nondiabetic patients at 12 months post-surgery. Conclusion LSG is highly effective at interfering with glucose and lipid levels as well as total bile acid levels in prediabetic patients in the first year postoperatively. Thus, LSG is indeed an alternative for overweight and obese prediabetic patients.


2020 ◽  
Author(s):  
Tsz Kin Mak ◽  
Shifang Huang ◽  
Bingsheng Guan ◽  
Hoyin Au ◽  
Tsz Hong Chong ◽  
...  

Abstract Background: Few articles have studied individuals with prediabetes after sleeve gastrectomy. Bile acid and lipid levels remain inconsistent in postbariatric patients. The purpose of this study was to explore bile acid, glucose, lipid, and liver enzyme changes in patients with different diabetes statuses who underwent sleeve gastrectomy. The impact of bariatric surgery and its potential benefits for prediabetic patients was also discussed.Methods: A total of 202 overweight and obese patients who underwent bariatric surgery in our hospital between January 2016 and October 2018 were retrospectively reviewed. Patients were divided into prediabetes (n=32), nondiabetes (n=144), and diabetes (n=26) groups and analysed. Glucose and lipid data were collected from medical records at baseline and at each follow-up visit.Result: Significant improvements in body weight, glucose and lipid levels, and liver enzymes (P≤0.05) in prediabetic patients were found throughout the first year postoperatively. Improvement in glycaemic control was first seen one month postoperatively, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, which was associated with ALT improvement in prediabetic patients 1-year post-surgery. There were no significant differences in HbA1c, glucose, or triglycerides (TGs) between prediabetic and T2DM patients or between prediabetic and nondiabetic patients at 12 months post-surgery.Conclusion: LSG is highly effective at interfering with glucose and lipid levels as well as total bile acid levels in prediabetic patients in the first year postoperatively. Thus, LSG is indeed an alternative for overweight and obese prediabetic patients.


2020 ◽  
Author(s):  
Tsz Kin Mak ◽  
Shifang Huang ◽  
Bingsheng Guan ◽  
Hoyin Au ◽  
Tsz Hong Chong ◽  
...  

Abstract Background: Few articles have studied pre-diabetes after sleeve gastrectomy. Bile acid, and lipid level remains inconsistent in post-bariatric patients. To explore bile acid and glucose, lipid, and liver enzyme changes in different diabetic status underwent sleeve gastrectomy. To discuss the impact of bariatric surgery and its potential benefits to pre-diabetics Methods: 202 overweight and obese patients underwent bariatric surgery between January 2016 and October 2018 in our hospital were retrospectively reviewed. They were divided into Pre-diabetes (n=32), Non-diabetes (n=144), and Diabetes (n=26) and analyzed respectively. Data of glucose and lipid were collected from medical records from baseline and each follow-up visit. Result: Significant improvement in body weight, glucose and lipid level, and liver enzyme at P≤0.05 in prediabetics were found throughout first year post-op. Improvement of glycemic control was first seen in a month post op, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, associated with ALT improvement, in pre-diabetes 1-year post-surgery. There was no significant differences in HbA1c, glucose, and triglycerides (TG) between Pre-diabetics and T2DM nor between prediabetics and non-diabetics at 12 months post-surgery. Conclusion: LSG is highly effective in interfering glucose and lipid level as well as total bile acid of prediabetics in the first year post operation. Thus, LSG is indeed an alternative for overweight and obese pre-diabetics


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 878
Author(s):  
Arnaud Bernard ◽  
Johanne Le Beyec-Le Bihan ◽  
Loredana Radoi ◽  
Muriel Coupaye ◽  
Ouidad Sami ◽  
...  

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m2) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Marwan Alkassis ◽  
Fady Gh Haddad ◽  
Joseph Gharios ◽  
Roger Noun ◽  
Ghassan Chakhtoura

Introduction. Obesity is increasing worldwide and in Lebanon with a negative impact on the quality of life. The primary objective of this study is to measure the quality of life in obese subjects before and after bariatric surgery, depending on age, sex, and degree of weight loss. A secondary objective is to determine the impact of bariatric surgery on comorbidities associated with obesity. Materials and methods. Patients undergoing laparoscopic sleeve gastrectomy for BMI ≥ 30 kg/m2 between August 2016 and April 2017 were included. Participants completed the Moorehead-Ardelt Quality of Life Questionnaire II (MA II) prior to operation and one year after. Statistical analysis was carried out using SPSS statistics version 20.0. Results. 75 patients participated in the study. The majority were women (75%), and the mean age was 36.3 years. The mean weight loss was 36.57 kg (16–76). Initially, the total MA II score was −0.33 ± 0.93. Postoperatively, it increased to 1.68 ± 0.62 (p≤0.001). All MA II parameters improved after surgery (p≤0.001), but this improvement was independent of age and sex. Improvement in self-esteem, physical activity, work performance, and sexual pleasure was influenced by the degree of weight loss (p≤0.001). All comorbidities associated with obesity regressed significantly after sleeve gastrectomy (p<0.05) with the exception of gastroesophageal reflux and varicose veins of the lower limbs. Conclusion. Sleeve gastrectomy improves quality of life and allows reduction of comorbidities.


2018 ◽  
Vol 22 (3) ◽  
pp. 548-552
Author(s):  
O.V. Perekhrestenko

The rapid progress of obesity surgery dictates the necessity to study the quality of life of patients after bariatric procedures. The aim of the study is to assess the dynamics of quality of life of patients with morbid obesity after biliopancreatic diversion in the modification of Hess-Marceau and the sleeve gastrectomy in order to improve the results of surgical treatment of the specified category of patients. The results of surgical treatment of 205 patients with morbid obesity who performed sleeve gastrectomy (main group — 105 patients) or biliopancreatic diversion by Hess-Marceau (comparison group — 100 patients) were analyzed. The study of the dynamics of quality of life of patients was performed in according the Moorehead-Ardelt II method. Statistical data processing was performed using the methods of variational and descriptive statistic using Statistica 6.0 statistical analysis package. Installed that biliopancreatic diversion by Hess-Marceau and sleeve gastrectomy allowed to significantly improve the quality of life of patients with an increase of the quality of life index with -1.5±0.7 in the comparison group and -1.6±0,6 in the main group up to 1.8±0.3 and 2.0±0.4 respectively (p<0.05 compared to pre-operative data) 60 months after surgery. A more pronounced positive dynamics of quality of life in patients of the main group in the time interval of 12–24 months after the operation was achieved due to the absence of severe late metabolic complications and undesirable side effects of biliopancreatic diversion and laparoscopic access for sleeve gastrectomy in 54.3% of patients. Thus, the quality of life of patients with morbid obesity before performing bariatric surgery is critically low and significantly improved after biliopancreatic diversion by Hess-Marceau as well as sleeve gastrectomy. The impact of bariatric surgery on the duration and quality of life of patients requires further multicenter randomized trials.


2015 ◽  
Vol 74 (3) ◽  
pp. 258-267 ◽  
Author(s):  
Mark R. Hobden ◽  
Laetitia Guérin-Deremaux ◽  
Ian Rowland ◽  
Glenn R. Gibson ◽  
Orla B. Kennedy

Alterations in the composition and metabolic activity of the gut microbiota appear to contribute to the development of obesity and associated metabolic diseases. However, the extent of this relationship remains unknown. Modulating the gut microbiota with non-digestible carbohydrates (NDC) may exert anti-obesogenic effects through various metabolic pathways including changes to appetite regulation, glucose and lipid metabolism and inflammation. The NDC vary in physicochemical structure and this may govern their physical properties and fermentation by specific gut bacterial populations. Much research in this area has focused on established prebiotics, especially fructans (i.e. inulin and fructo-oligosaccharides); however, there is increasing interest in the metabolic effects of other NDC, such as resistant dextrin. Data presented in this review provide evidence from mechanistic and intervention studies that certain fermentable NDC, including resistant dextrin, are able to modulate the gut microbiota and may alter metabolic process associated with obesity, including appetite regulation, energy and lipid metabolism and inflammation. To confirm these effects and elucidate the responsible mechanisms, further well-controlled human intervention studies are required to investigate the impact of NDC on the composition and function of the gut microbiota and at the same time determine concomitant effects on host metabolism and physiology.


2021 ◽  
Author(s):  
Sophia M.-T. Schmitz ◽  
Andreas Kroh ◽  
Alexander Koch ◽  
Jonathan F. Brozat ◽  
Christine Stier ◽  
...  

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a common condition in patients with obesity. Bariatric surgery has often been proposed as a viable treatment option, but the ideal surgical procedure remains unclear. Inconsistently, reports on postoperative deterioration of liver function put further doubt on which technique to apply. Aim of this study was to assess the impact of Roux-en-Y-gastric bypass (RYGB) and sleeve gastrectomy (SG) on the postoperative recovery of liver function. Methods A total of 175 patients with obesity that underwent bariatric surgery in our institution were included in this prospective cohort study. BMI, laboratory values, and liver function capacity (using LiMAx) were assessed preoperatively and at 6 and 12 months postoperatively. Generalized linear model (GLM) was performed to determine variables influencing liver function capacity after the operation. Results Prior to operations, 64% of patients presented with a diminished liver function capacity, as measured by LiMAx test. Liver function capacity significantly recovered after 12 months in the SG group (300 μg/kg/h preop vs. 367 μg/kg/h postop) but not in the RYGB group (306 μg/kg/h preop vs. 349 μg/kg/h). Preoperative factors impeding liver function recovery included type 2 diabetes mellitus (T2DM), weight, male sex, AST/thrombocyte ratio (APRI), and gamma-glutamyltransferase (GGT). Conclusion Bariatric surgery, especially sleeve gastrectomy, leads to an improvement of liver function. However, in some patients with T2DM, higher preoperative weight and male sex postoperative deterioration of liver function capacity may occur. Graphical abstract


2021 ◽  
Vol 12 ◽  
Author(s):  
Tamara Heintze ◽  
Denise Wilhelm ◽  
Thierry Schmidlin ◽  
Ute Hofmann ◽  
Ulrich M. Zanger ◽  
...  

NADPH:cytochrome P450 oxidoreductase (POR) is the obligate electron donor for microsomal cytochrome P450 (CYP) enzymes involved in the biosynthesis of endogenous substances like bile acids and other steroids as well as in the oxidative metabolism of xenobiotics. P450 oxidoreductase also supports other redox enzymes in fatty acid and cholesterol pathways. Recently, we have established CRISPR/Cas9-mediated POR knockdown in a human hepatic cell model, HepaRG, and demonstrated the differential effects of limited POR expression on CYP activity. The aim of the present work was to systematically investigate the impact of POR knockdown with a focus on the expression of ADME (absorption, distribution, metabolism, and excretion) genes and related regulators. Functional consequences have been assessed using quantitative mass spectrometry for targeted metabolomics covering bile acids, and cholesterol and its precursors, and for untargeted proteomics. In addition to the previously described alteration of RNA expression of CYP genes, we showed significant downregulation of transcriptional regulators of drug metabolism and transport, including NR1I3 (CAR), NR1I2 (PXR), NR1H4 (FXR), and NR1H3 (LXRα) in cells with POR gene disruption. Furthermore, POR knockdown resulted in deregulated bile acid and cholesterol biosynthesis demonstrated by low levels of cholic acid derivates and increased concentrations of chenodeoxycholic acid derivates, respectively. Systemic effects of POR knockdown on global protein expression were indicated by downregulation of several metabolic pathways including lipid metabolism and biological oxidation reactions. The deduced protein network map corroborates CYP enzymes as direct interaction partners, whereas changes in lipid metabolism and homeostasis are the result of indirect effects. In summary, our results emphasize a widespread role of POR in various metabolic pathways and provide the first human data on the effects of diminished POR expression on drug and endogenous metabolism in a genomeedited HepaRG cell model.


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