Bile acid profiles within the enterohepatic circulation in a diabetic rat model after bariatric surgeries

Am J Physiol Gastrointest Liver Physiol. 2018 May 1;314(5):G537-G546. doi: 10.1152/ajpgi.00311.2017. Epub 2017 Dec 21.

Abstract

Bile acids (BAs), which are synthesized in the liver and cycled in the enterohepatic circulation, have been recognized as signaling molecules by activating their receptors in the intestine and liver. Serum taurine-conjugated BAs have been shown to be elevated after bariatric surgeries although the postoperative BA profiles within the enterohepatic circulation have not been investigated. Clarification of these profiles could help explain the mechanisms by which bariatric surgery leads to BA profile alterations and subsequent metabolic effects. We performed duodenal-jejunal bypass (DJB), sleeve gastrectomy (SG), and sham procedures in an obese diabetic rat model induced by high-fat diet and streptozotocin. The weight loss and antidiabetic effects were evaluated postsurgery. BA profiles in the systemic serum and within the enterohepatic circulation were analyzed, together with the expression of related BA transporters and enzymes at week 12 after surgery. Compared with sham, SG induced sustained weight loss, and both DJB and SG significantly improved glucose tolerance and insulin sensitivity with enhanced glucagon-like peptide 1 secretion. Similar to changes in the serum, BAs, especially taurine-conjugated species, were also elevated in the enterohepatic circulation (bile and portal vein) after DJB and SG. In addition, the expression of key BA transporters and conjugational enzymes was elevated postoperatively, whereas the enzymes responsible for BA synthesis were decreased. In conclusion, DJB and SG elevated BA levels in the systemic serum and enterohepatic circulation, especially taurine-conjugated species, which likely indicates increased ileal reabsorption and hepatic conjugation rather than synthesis. NEW & NOTEWORTHY Bile acids (BAs) have been implicated as potential mediators of the weight-independent effects of bariatric surgery. For the first time, we discovered that duodenal-jejunal bypass and sleeve gastrectomy elevated BAs, particularly the taurine-conjugated species in the enterohepatic circulation, likely through the promotion of ileal reabsorption and hepatic conjugation rather than BA synthesis. These findings will improve our understanding of BA metabolism after bariatric surgery and their subsequent metabolic effects.

Keywords: bile acids; duodenal-jejunal bypass; enterohepatic circulation; sleeve gastrectomy; type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bariatric Surgery* / adverse effects
  • Bariatric Surgery* / classification
  • Bariatric Surgery* / methods
  • Bile Acids and Salts* / blood
  • Bile Acids and Salts* / metabolism
  • Blood Glucose / metabolism
  • Body Weight / physiology
  • Diabetes Mellitus, Experimental / metabolism
  • Diabetes Mellitus, Type 2
  • Enterohepatic Circulation / physiology*
  • Insulin Resistance
  • Intestinal Reabsorption / physiology
  • Obesity* / metabolism
  • Obesity* / physiopathology
  • Obesity* / surgery
  • Postoperative Complications / metabolism*
  • Rats
  • Taurine / metabolism*

Substances

  • Bile Acids and Salts
  • Blood Glucose
  • Taurine