The findings support the effects of BAs on satiety , lipid and cholesterol metabolism , incretins and glucose homoeostasis , energy metabolism , gut microbiota and endoplasmic reticulum stress following bariatric surgery .
Many of these metabolic effects are modulated through the BA receptors FXR and TGR5 .
We also explore a possible link between BAs and carcinogenesis following bariatric surgery .
Conclusions : Overall there is good evidence to support the role of BAs in the metabolic effects of bariatric surgery through the above mechanisms .
BAs could serve as a novel therapeutic pharmacological target for the treatment of obesity and its associated co-morbidities
Background : Bariatric surgery is currently the most efficacious treatment for obesity and its associated metabolic co-morbidities , such as diabetes .
The metabolic improvements occur through both weight-dependent and weight-independent mechanisms .
Bile acids ( BAs ) have emerged as key signalling molecules that have a central role in modulating many of the physiological effects seen after bariatric surgery .
This systematic review assesses the evidence from both human and animal studies for the role of BAs in reducing the metabolic complications of obesity following bariatric surgery .
GLUCAGON-LIKE PEPTIDE-1 7-36: A PHYSIOLOGICAL INCRETIN IN MAN
The physiological role of glucagon-like peptide-1 7 - 36 amide ( GLP-1 7 - 36 ) in man was investigated . GLP-1 7 - 36-like immunoreactivity was found in the human bowel ; its circulating level rose after oral glucose and after a test breakfast . When it was infused into seven volunteers at a rate to mimic its postpr and ial plasma concentration in the fasting state , plasma insulin levels rose significantly and glucose and glucagon concentrations fell . During an intravenous glucose load , it greatly enhanced insulin release and significantly reduced peak plasma glucose concentrations , compared with a control saline infusion , even inducing postinfusion reactive hypoglycaemia . By comparison , infusion of glucose-dependent insulinotropic peptide ( GIP ) to physiological levels was less effective in stimulating insulin release . These observations suggest that GLP-1 7 - 36 is a physiological incretin and that it is more powerful than GIP . The observation of greatly increased postpr and ial plasma GLP-1 7 - 36 levels in patients with postgastrectomy dumping syndrome suggests that it may mediate the hyperinsulinaemia and reactive hypoglycaemia of this disorder
The findings support the effects of BAs on satiety , lipid and cholesterol metabolism , incretins and glucose homoeostasis , energy metabolism , gut microbiota and endoplasmic reticulum stress following bariatric surgery .
Many of these metabolic effects are modulated through the BA receptors FXR and TGR5 .
We also explore a possible link between BAs and carcinogenesis following bariatric surgery .
Conclusions : Overall there is good evidence to support the role of BAs in the metabolic effects of bariatric surgery through the above mechanisms .
BAs could serve as a novel therapeutic pharmacological target for the treatment of obesity and its associated co-morbidities
Background : Bariatric surgery is currently the most efficacious treatment for obesity and its associated metabolic co-morbidities , such as diabetes .
The metabolic improvements occur through both weight-dependent and weight-independent mechanisms .
Bile acids ( BAs ) have emerged as key signalling molecules that have a central role in modulating many of the physiological effects seen after bariatric surgery .
This systematic review assesses the evidence from both human and animal studies for the role of BAs in reducing the metabolic complications of obesity following bariatric surgery .