Bile Routing Modification Reproduces Key Features of Gastric Bypass in Rat.
Ann Surg
; 262(6): 1006-15, 2015 Dec.
Article
en En
| MEDLINE
| ID: mdl-25575265
ABSTRACT
OBJECTIVE:
To evaluate the role of bile routing modification on the beneficial effects of gastric bypass surgery on glucose and energy metabolism.BACKGROUND:
Gastric bypass surgery (GBP) promotes early improvements in glucose and energy homeostasis in obese diabetic patients. A suggested mechanism associates a decrease in hepatic glucose production to an enhanced intestinal gluconeogenesis. Moreover, plasma bile acids are elevated after GBP and bile acids are inhibitors of gluconeogenesis.METHODS:
In male Sprague-Dawley rats, we performed bile diversions from the bile duct to the midjejunum or the mid-ileum to match the modified bile delivery in the gut occurring in GBP. Body weight, food intake, glucose tolerance, insulin sensitivity, and food preference were analyzed. The expression of gluconeogenesis genes was evaluated in both the liver and the intestine.RESULTS:
Bile diversions mimicking GBP promote an increase in plasma bile acids and a marked improvement in glucose control. Bile bioavailability modification is causal because a bile acid sequestrant suppresses the beneficial effects of bile diversions on glucose control. In agreement with the inhibitory role of bile acids on gluconeogenesis, bile diversions promote a blunting in hepatic glucose production, whereas intestinal gluconeogenesis is increased in the gut segments devoid of bile. In rats fed a high-fat-high-sucrose diet, bile diversions improve glucose control and dramatically decrease food intake because of an acquired disinterest in fatty food.CONCLUSIONS:
This study shows that bile routing modification is a key mechanistic feature in the beneficial outcomes of GBP.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Bilis
/
Glucemia
/
Ácidos y Sales Biliares
/
Derivación Gástrica
/
Metabolismo Energético
Tipo de estudio:
Evaluation_studies
Límite:
Animals
Idioma:
En
Revista:
Ann Surg
Año:
2015
Tipo del documento:
Article
País de afiliación:
Francia