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. 2019 Jun 7;8(6):815.
doi: 10.3390/jcm8060815.

Bile Acid and Fibroblast Growth Factor 19 Regulation in Obese Diabetics, and Non-Alcoholic Fatty Liver Disease after Sleeve Gastrectomy

Hsien-Hao Huang  1   2 , Wei-Jei Lee  3   4 , Shu-Chun Chen  5   6   7 , Tung-Fang Chen  8 , Shou-Dong Lee  9 , Chih-Yen Chen  10   11   12
Affiliations

Bile Acid and Fibroblast Growth Factor 19 Regulation in Obese Diabetics, and Non-Alcoholic Fatty Liver Disease after Sleeve Gastrectomy

Hsien-Hao Huang et al. J Clin Med. .

Abstract

Background: Sleeve gastrectomy (SG) is an effective treatment for obesity and type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD); however, the mechanism is not completely understood. Bile acids and fibroblast growth factors (FGFs) are involved in the regulation of energy metabolism.

Methods: We investigated the roles of total bile acid and FGF 19 in T2DM remission and NAFLD improvement in obese subjects undergoing SG. A total of 18 patients with obesity and T2DM undergoing laparoscopic SG were enrolled in this study. Serial plasma total bile acid and FGF 19 levels were measured, while the fatty liver index was calculated before and after surgery.

Results: The FGF 19 level significantly increased, and the total bile acid level and fatty liver index decreased 1 year after surgery. The complete T2DM remission rate was 66.7% one year after surgery; the complete remitters had significantly lower FGF 19 levels and higher insulin levels than the non-complete remitters. The complete remitters also had significantly decreased total bile acid levels and increased FGF 19 levels 1 year after surgery compared with those before surgery. The fatty improvers had significantly decreased total bile acid levels and increased FGF 19 levels 1 year after surgery compared with those before surgery.

Conclusion: The total bile acids level and fatty liver index decreased, and the FGF 19 levels increased 1 year after SG. Both T2DM complete remitters and NAFLD improvers showed significantly decreased total bile acid levels and increased FGF 19 levels 1 year after SG. Plasma total bile acids and FGF 19 might have roles in T2DM remission and NAFLD improvement. Low preoperative FGF 19 levels might be a predictor for NAFLD improvement after SG.

Keywords: FGF 19; diabetes mellitus; non-alcoholic fatty liver disease; sleeve gastrectomy; total bile acid.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Serum levels of total bile acid (A) and fibroblast growth factor 19 (B) in patients with obesity and type 2 diabetes mellitus before (M0) and 3 months (M3) and 1 year (M12) after sleeve gastrectomy. # p < 0.05 compared with M0.
Figure 2
Figure 2
Relationships of the levels of fibroblast growth factor 19 with the levels of C-peptide (A), ALT (B), and total bile acid (C) in the patients with obesity and diabetes mellitus 1 year after sleeve gastrectomy. ALT, alanine aminotransferase.
Figure 3
Figure 3
Serum levels of total bile acid (A) and fibroblast growth factor 19 (B) and HOMA-β index (C) in the DM-CR and DM-non-CR groups before (M0) and 3 months (M3) and 1 year (M12) after sleeve gastrectomy. * p < 0.05 compared between the DM-CR and DM-non-CR groups, # p < 0.05 compared with MDM-CR, complete remitters of diabetes mellitus; DM-non-CR, non-complete remitters of diabetes mellitus; HOMA-β, homeostasis model assessment-β.
Figure 4
Figure 4
Serum levels of total bile acid (A) and fibroblast growth factor 19 (B) and γ-glutamyltranspeptidase (C) in the FL-I and FL-non-I groups before (M0) and 3 months (M3) and 1 year (M12) after sleeve gastrectomy. * p < 0.05 compared between FL-I and FL-non-I groups, # p < 0.05 compared with MFL-I, improvers of fatty liver; FL-non-I, non-improvers of fatty liver.
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References

    1. Chiang J.Y. Bile acids: Regulation of synthesis. J. Lipid Res. 2009;50:1955–1966. doi: 10.1194/jlr.R900010-JLR200. - DOI - PMC - PubMed
    1. Lefebvre P., Cariou B., Lien F., Kuipers F., Staels B. Role of bile acids and bile acid receptors in metabolic regulation. Physiol. Rev. 2009;89:147–191. doi: 10.1152/physrev.00010.2008. - DOI - PubMed
    1. Chiang J.Y. Bile acid metabolism and signaling. Compr. Physiol. 2013;3:1191–1212. - PMC - PubMed
    1. Düfer M., Hörth K., Wagner R., Schittenhelm B., Prowald S., Wagner T.F., Oberwinkler J., Lukowski R., Gonzalez F.J., Krippeit-Drews P., et al. Bile acids acutely stimulate insulin secretion of mouse β-cells via farnesoid X receptor activation and K(ATP) channel inhibition. Diabetes. 2012;61:1479–1489. doi: 10.2337/db11-0815. - DOI - PMC - PubMed
    1. Shaham O., Wei R., Wang T.J., Ricciardi C., Lewis G.D., Vasan R.S., Carr S.A., Thadhani R., Gerszten R.E., Mootha V.K. Metabolic profiling of the human response to a glucose challenge reveals distinct axes of insulin sensitivity. Mol. Syst. Biol. 2008;4:214. doi: 10.1038/msb.2008.50. - DOI - PMC - PubMed

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