期刊
CELLULAR AND MOLECULAR GASTROENTEROLOGY AND HEPATOLOGY
卷 8, 期 2, 页码 235-246出版社
ELSEVIER INC
DOI: 10.1016/j.jcmgh.2019.04.014
关键词
Bariatric Surgery; Bile Acids; Type 2 Diabetes; Rouxen Y Gastric Bypass; Glucagon-Like Polypeptide 1 (GLP-1)
资金
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health [DK059637, DK020593, DK058404, F32 DK103474, R01 DK105847]
- Society of American Gastrointestinal and Endoscopic Surgeons
Bariatric surgery is the most effective and durable treatment for morbid obesity, with an unexplained yet beneficial side effect of restoring insulin sensitivity and improving glycemia, often before weight loss is observed. Among the many contributing mechanisms often cited, the altered handling of intestinal bile acids is of considerable therapeutic interest. Here, we review a growing body of literature examining the metabolic effects of bile acids ranging from their physical roles in dietary fat handling within the intestine to their functions as endocrine and paracrine hormones in potentiating responses to bariatric surgery. The roles of 2 important bile acid receptors, Takeda G-protein coupled receptor (also known as G-protein coupled bile acid receptor) and farnesoid X receptor, are highlighted as is downstream signaling through glucagon-like polypeptide 1 and its cognate receptor. Additional improvements in other phenotypes and potential contributions of commensal gut bacteria, such as Akkermansia muciniphila, which are manifest after Rouxen-Y gastric bypass and other emulations, such as gallbladder bile diversion to the ileum, are also discussed.
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