ECE2020 Audio ePoster Presentations Diabetes, Obesity, Metabolism and Nutrition (285 abstracts)
Secretion of bile acids in different techniques of bariatric surgery
Inés Jiménez 1 , Isabel Ortega 1 , Angelica Larrad 1 , Ana Barabash 1 , Elena Bordiu 1 , Andrés Sánchez-Pernaute 2 , Natalia Pérez-Ferre 1 , Clara Marcuello 1 , Pilar Matía 1 , Antonio J Torres 2 , Maria Angeles Cuadrado 1 , Alfonso L Calle-Pascual 1 & Miguel A Rubio 1
1Hospital Clinico Universitario San Carlos, Endocrinology, Madrid, Spain; 2Hospital Clinico Universitario San Carlos, General Surgery, Madrid, Spain
Background: Bariatric surgery (BS) has proven to be an effective and sustainable long-term treatment in the remission of metabolic disorders. Bile acids (BAs) are involved in the improvement of metabolic comorbidities by acting on the distal ileum (releasing GLP1, PYY and FGF19) and on the microbiota. Our aim is to verify whether the formation of ABs depends on the type of bariatric surgery.
Subjects and Methods: 21 patients (81% women) underwent bariatric surgery (BS); 9 patients were selected to Roux-en-Y gastric bypass (YRGB) and 12 to Biliopancreatic-diversion (BPD, type SADIS). The patients (with informed consent) were given a mixed meal test before (T1) and after 1 year post BS (T2), collecting samples at times 0-30-60-90-120 min for 15 fractions of ABs, conjugated and unconjugated forms (determined using a UPLC-tandem MS]. Statistics: descriptive mean ±
Results: Mean age: 50.2 (IQR: 43,354,5) y/o; BMI: 43.09 ± 5.80 kg/m2 in YRGB group vs 48.4 ± 5.27 kg/m2 SADI-S group. Type-2 diabetes mellitus was present in 56% and 58%, respectively. Total weight loss at one-year was 38.5% (IQR:27.9–44.9) for YRGB and 39.5% (31.4–42.4) in SADIS subjects. Both total and conjugate baseline ABs increased significantly at one year of follow-up (T2). Although BAs increased twice as much after BPD as with YRGB, there were no significant differences between the two surgical techniques. Glycine conjugated BAs (glycocolic, Glycodeoxycholic, and Glycoqueneoxycholic) were the most prominent. (see table). The increase of total postprandial BAs measured by AUC was also significantly increased at one year in both techniques (YRGB: 174.95 T1 vs 416.28 T2; SADI-S 226.08 T1 vs 386.60 T2; P < 0.05)
| YRGB | SADIS | |||||
| T1 | T2 | P | T1 | T2 | P | |
| TOTAL BAs (mg/l) | 0.873 | 1.666 | P = 0.038 | 1.049 | 3.467 | P = 0.003 |
| CONJUGATED BAs (mg/l) | 0.236 | 1.004 | P = 0.028 | 0.431 | 2.581 | P = 0.005 |
| UNCONJUGATED BAs (mg/l) | 0.651 | 0.543 | P = 0.3 | 0.624 | 0.744 | P = 0.158 |
Conclusions: BAs are increased after one year of bariatric surgery, regardless of the bariatric technique, in particular glycine conjugated forms that are dependent on intestinal microbiota and may play a prominent role in the remission of metabolic comorbidities.
Funding Instituto de Salud Carlos III (FIS 16/01655) co-funding with European Regional Development Fund (ERDF).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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