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The Contributing Role of Bile Acids to Metabolic Improvements After Obesity and Metabolic Surgery

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Abstract

Obesity and metabolic surgery (OMS) leads to several metabolic improvements, which often occur prior to substantial weight loss. Therefore, other factors in addition to weight loss contribute to the metabolic benefits. This literature review offers an overview of studies investigating bile acids (BAs) and their metabolic effects after OMS. Rearrangement of enterohepatic circulation, changes in BA synthesis, BA conjugation, intestinal reabsorption, and alterations in the gut microbiota are potential mechanisms for altered BA profiles after surgery. Increased BA levels are associated with improved glucose homeostasis and lipid profiles, which are mediated by two major receptors: the Transmembrane G-protein Coupled Receptor and the Farnesoid X Receptor. Therefore, pharmacological manipulation of BAs and their receptors may be viable targets for less invasive obesity treatment.

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Abbreviations

BAs:

Bile acids

BAT:

Brown adipose tissue

CA:

Cholic acid

CDCA:

Chenodeoxycholic acid

DCA:

Deoxycholic acid

EE:

Energy expenditure

FGF19:

Fibroblast growth factor 19

FXR:

Farnesoid X receptor

GLP-1:

Glucagon like peptide 1

II:

Ileal interposition

LAGB:

Laparoscopic adjustable gastric banding

LCA:

Lithocholic acid

M2:

Muscarinic receptor

OMS:

Obesity and metabolic surgery

PYY:

Peptide YY

REE:

Resting energy expenditure

RYGB:

Roux-en-Y gastric bypass

S1PR2:

Sphingosine-1-phosphate receptor 2

SG:

Sleeve gastrectomy

SHP:

Small heterodimer partner

T2DM:

Type 2 diabetes mellitus

TGR-5:

Transmembrane G-protein coupled receptor

TUDCA:

Tauroursodeoxycholic acid

UDCA:

Ursodeoxycholic acid

VSG:

Vertical sleeve gastrectomy

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Authors and Affiliations

  1. College of Health Professions, North Dakota State University, PO Box 6050, Fargo, ND, 58108-6050, USA

    Farnaz Fouladi & Kristine J. Steffen

  2. Neuropsychiatric Research Institute, Fargo, ND, USA

    James E. Mitchell & Kristine J. Steffen

  3. University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA

    James E. Mitchell

  4. Department of Psychology, George Mason University, Fairfax, VA, USA

    Joseph A. Wonderlich

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  1. Farnaz Fouladi
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  2. James E. Mitchell
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  4. Kristine J. Steffen
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Correspondence to Kristine J. Steffen.

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Farnaz Fouladi, James E. Mitchell, and Joseph A. Wonderlich have no conflict of interest. Kristine J. Steffen has previous and current grant support from NIH. She also receives royalties from a previous contribution to UptoDate.

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Fouladi, F., Mitchell, J.E., Wonderlich, J. et al. The Contributing Role of Bile Acids to Metabolic Improvements After Obesity and Metabolic Surgery. OBES SURG 26, 2492–2502 (2016). https://doi.org/10.1007/s11695-016-2272-3

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