Advertisement

The Role of Bile Acids in Gut-Hormone-Induced Weight Loss After Bariatric Surgery: Implications for Appetite Control and Diabetes

  • Rachel E. Roberts
  • Jamsaid Alaghband-Zadeh
  • Carel W. Le Roux
Chapter

Abstract

The gut hormones peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) play an integral role in appetite control and energy homeostasis. GLP-1 is an incretin that stimulates insulin secretion thereby improving glycemic control. Both nutrients and bile acids (BAs) are known stimulators of PYY and GLP-1 secretion from endocrine L-cells of the distal small intestine. Recent evidence implicates PYY and GLP-1 as contributing to the improvement in glycemic control and weight loss following gastric bypass (GBP) surgery for the treatment of obesity. The mechanisms for the increased levels of PYY and GLP-1 seen after GBP are not entirely understood and several hypotheses have been put forward. This chapter focuses on the role that altered gastrointestinal (GI) anatomy following GBP plays on BA and nutrient delivery to the distal small intestine. It is proposed that quicker transit and greater exposure of both nutrients and BAs to the distal terminal ileum results in increased PYY and GLP-1 secretion after GBP which contributes to the weight loss and improvement in type 2 diabetes seen after this procedure. Following GBP hunger is suppressed and there is a well-described change in feeding behavior whereby patients tend to eat fewer meals and snacks per day with a selective reduction of calorically dense high-carbohydrate foods.

Keywords

Bariatric Surgery Bile Acid Glycemic Control Bile Acid Concentration Distal Small Intestine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

ARC

Arcuate nucleus

AUC

Area under the curve

BND

Gastric banding

BPD

Biliopancreatic diversion

D2

Type 2 iodothyronine deiodinase

FGF-19

Fibroblast growth factor-19

FXRα

Farnesoid X receptor α

GBP

Gastric bypass

GI

Gastrointestinal

GK

Goto Kakizaki rats

GLP-1

Glucagon-like peptide 1

HbA1C

Hemoglobin A1C

HOMA-IR

Homeostasis model assessment for insulin resistance

MAPK

Mitogen-activated protein kinase

mM

Millimolar

OGTT

Oral glucose tolerance test

PI3K

Phosphoinositide 3-kinase

PYY

Peptide YY

RYGBP

Roux-en-Y gastric bypass

T2DM

Type 2 diabetes mellitus

TGR5

G-protein-coupled receptor TGR5

References

  1. Adrian TE, Ballantyne GH, Basson MD, Bilchik AJ, Graham S, Longo WE, Modlin IM, Tierney RP Gut 1993;34:1219–24.PubMedCrossRefGoogle Scholar
  2. Angelin B, Björkhem I, Einarsson K, Ewerth S J Clin Invest. 1982;70:724–31.PubMedCrossRefGoogle Scholar
  3. Anini Y, Chariot J, Cuber JC, Fu-Cheng X, Kervran A, Roz C Pflugers Arch. 1999;438:299–306.PubMedCrossRefGoogle Scholar
  4. Aponte GW, Fink AS, Meyer JH, Tatemoto K, Taylor IL Am J Physiol. 1985;249:G745–50.PubMedGoogle Scholar
  5. Armstrong DN, Ballantyne GH, Krenz HK, Modlin IM Gut 1993;34:483–8.PubMedCrossRefGoogle Scholar
  6. Ballantyne GH, Adrian TE, Bilchik AJ, Longo WE, Modlin IM, Savoca PE, Sussman J, Vukasin AP Am J Physiol. 1989;257:G715–24.PubMedGoogle Scholar
  7. Batterham RL, Bloom SR, Cohen MA, Ellis SM, Frost GS, Ghatei MA, le Roux CW, Withers DJ N Engl J Med. 2003;349:941–8.PubMedCrossRefGoogle Scholar
  8. Biertho L, Gagner M, Herron D, Horber FF, Inabnet WB, Pomp A, Ricklin T, Steffen R J Am Coll Surg. 2003;197:536–44.PubMedCrossRefGoogle Scholar
  9. Borg CM, Aylwin SJB, Bloom SR, Ghatei MA, le Roux CW, Patel AGBr J Surg. 2006;93:210–5.PubMedCrossRefGoogle Scholar
  10. Bray GA, Gallagher TFJ Lancet. 1968;1:1066–7.PubMedCrossRefGoogle Scholar
  11. Brolin RE. JAMA 2002;288:2793–96.PubMedCrossRefGoogle Scholar
  12. Brolin RE, Cody RP, Kenler HA, LaMarca LB J Gastrointest Surg. 2002;6:195–203.PubMedCrossRefGoogle Scholar
  13. Bryant MG, Bloom SR, Demling L, Domschke S, Domschke W, Hobbs S, Mitznegg P, Polak JM, Ruppin H Gut 1983;24:114–9.PubMedCrossRefGoogle Scholar
  14. Buchwald H, Avidor Y, Braunwald E, Fahrbach K, Jensen MD, Pories W, Schoelles K JAMA 2004;292:1724–37.PubMedCrossRefGoogle Scholar
  15. Chaikomin R, Doran S, Feinle-Bisset C, Horowitz M, Jones KL, O’Donovan D, Rayner CK Am J Physiol Endocrinol Metab. 2005;289:E504–7.PubMedCrossRefGoogle Scholar
  16. Champe PC, Harvey RA, Ferrier DR In: Champe PC, Harvey RA, editors. Biochemistry. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 217–42.Google Scholar
  17. Chan JL, Goldfine AB, Mantzoros CS, Mun EC, Stoyneva V Obesity (Silver Spring) 2006;14:194–8.CrossRefGoogle Scholar
  18. Clements RH, Gonzalez QH, Laws HL, Long CI, Wittert G Am J Surg. 2004;70:1–4.Google Scholar
  19. Cohen DE. In: Zakim D, Boyer TD, editors. Hepatology: a textbook of liver disease. Philadelphia: Saunders; 2003. p. 1713–43.Google Scholar
  20. Copeland P, Davis P, Kaplan L Obes Res. 2003;11:A17.CrossRefGoogle Scholar
  21. Couce M, Burguera B, Cottam D, Esplen J, Schauer PR, Teijeiro R Obes Res. 2003;11:A35.Google Scholar
  22. Cummings DE, Breen PA, Dellinger EP, Frayo RS, Ma MK, Purnell JQ, Weigle DS N Engl J Med. 2002;346:1623–30.PubMedCrossRefGoogle Scholar
  23. Cummings DE, Foster-Schubert KE, Overduin J J Clin Endocrinol Metab. 2004;89:2608–15.PubMedCrossRefGoogle Scholar
  24. DePaula AL, Halpern A, Macedo AL, Machado CA, Rassi N, Schraibman V, Silva LQ Surg Endosc. 2008;22:706–16.PubMedCrossRefGoogle Scholar
  25. Dietschy JM. J Lipid Res. 1968;9:297–309.PubMedGoogle Scholar
  26. Faraj M, Cianflone K, Jones P, Sniderman AD J Lipid Res. 2001;42:571–80.PubMedGoogle Scholar
  27. Faraj M, Blank D, Cianflone K, Havel PJ, Phelis S, Sniderman AD J Clin Endocrinol Metab. 2003;88:1594–602.PubMedCrossRefGoogle Scholar
  28. Fonseca VA, Jones MR, Rosenstock J, Truitt KE, Wang AC Diabetes Care. 2008;31:1479–84.PubMedCrossRefGoogle Scholar
  29. Fruhbeck G, Diez CA, Gil MJ N Engl J Med. 2004;350:308–9.PubMedCrossRefGoogle Scholar
  30. Garg A, Grundy SM Ann Intern Med. 1994;121:416–22.PubMedGoogle Scholar
  31. Geloneze B, Geloneze SR, Pareja JC, Pilla VF, Repetto EM, Tambascia MA Obes Surg. 2003;13:17–22.PubMedCrossRefGoogle Scholar
  32. Goldberg RB, Fonseca VA, Jones MR, Truitt KE Arch Intern Med. 2008;168:1531–40.PubMedCrossRefGoogle Scholar
  33. Gupta S, Dent P, Hylemon PB, Stravitz RT J Biol Chem. 2001;11:276.Google Scholar
  34. Halmi KA, Falk JR, Mason E, Stunkard A Int J Obes. 1981;5:457–64.PubMedGoogle Scholar
  35. Han SI, Dent P, Fang Y, Grant S, Gupta S, Hylemonm PB, Li W, Qiao L, Studer E Hepatology 2004;39:456–63.PubMedCrossRefGoogle Scholar
  36. Hertz AF. Ann Surg. 1913;58:466–72.PubMedCrossRefGoogle Scholar
  37. Holdstock C, Engstrom BE, Karlsson FA, Lind L, Obrvall M Sundbom M J Clin Endocrinol Metab. 2003;88:3177–83.PubMedCrossRefGoogle Scholar
  38. Holt JA, Billin AN, Bisi J, Donahee M, Goodwin B, Jones SA, Kliewer SA, Kozarsky KF, Luo G, Mansfield TA, McNeill YY, Wang DY Genes Dev. 2003;17:1581–91.PubMedCrossRefGoogle Scholar
  39. Houten SM, Auwerx J, Watanabe M EMBO J. 2006;25:1419–25.PubMedCrossRefGoogle Scholar
  40. Ikemoto S, Ezaki O, Higuchi M, Itakura H, Kawanaka K, Maruyama K, Tabata I, Takahashi M, Tange T, Tsunoda N, Yamamoto TT Am J Physiol. 1997;273:E37–45.PubMedGoogle Scholar
  41. Inagaki T, Choi M, Cummins CL, Gerard RD, Goodwin B, Jones SA, Kliewer SA, Luo G, Mangelsdorf DJ, McDonald JG, Moschetta A, Peng L, Repa JJ, Richardson JA Cell Metab. 2005;2:217–25.PubMedCrossRefGoogle Scholar
  42. Katsuma S, Hirasawa A, Tsujimoto G Biochem Biophys Res Commun. 2005;329:386–90.PubMedCrossRefGoogle Scholar
  43. Kawamata Y, Fujii R, Fujino M, Fujisawa Y, Fukusumi S, Habata Y, Harada M, Hinuma S, Hosoya M, Itoh T, Miwa M, Shintani Y, Yoshida H J Biol Chem. 2003;278:9435–40.PubMedCrossRefGoogle Scholar
  44. Kenler HA, Brolin RE, Cody RP Am J Clin Nutr. 1990;52:87–92.PubMedGoogle Scholar
  45. Korner J, Bessler M, Cirilo LJ, Conwell IM, Daud A, Restuccia NL, Wardlaw SL J Clin Endocrinol Metab. 2005;90:359–65.PubMedCrossRefGoogle Scholar
  46. Korner J, Bessler M, Conwell IM, Daud A, Inabnet W, Olivero-Rivera L, Restuccia NL, Taveras C Obesity 2006;14:1553–61.PubMedCrossRefGoogle Scholar
  47. Korner J, Inabnet W, Febres G, Conwell IM, McMahon DJ, Salas R, Taveras C, Schrope B, Bessler M Int J Obes. 2009;33:786–95.CrossRefGoogle Scholar
  48. Leonetti F, Bacci V, Basso MS, Basso N, Di Mario U, Lacobellis G, Lannucci CV, Perrotta N, Ribaudo MC, Silecchia G, Tiberti C, Zappaterreno A J Clin Endocrinol Metab. 2003;88:4227–31.PubMedCrossRefGoogle Scholar
  49. le Roux CW, Bloom SR, Fandriks L, Ghatei MA, Kokkinos A, Laurenius A, Lonroth H, Olbers T, Osborne A, Welbourn R, Werling M Ann Surg. 2007;246:780–5.PubMedCrossRefGoogle Scholar
  50. MacLean LD, Nohr CW, Rhode BM J Gastrointest Surg. 2001;5:525–30.PubMedCrossRefGoogle Scholar
  51. Makishima M, Hull MV, Learned RM, Luk A, Lustig KD, Mangelsdorf DJ, Okamoto AY, Repa JJ, Shan B, Tu H Science 1999;284:1362–5.PubMedCrossRefGoogle Scholar
  52. Mangelsdorf DJ, Beato M, Blumberg B, Chambon P, Evans RM, Herrlich P, Kastner P, Mark M, Schutz G, Thummel C, Umesono K Cell 1995;83:835–9.PubMedCrossRefGoogle Scholar
  53. Maruyama T, Itadani H, Miyamoto Y, Nakamura T, Okada H, Tamai Y, Tanaka K, Sugiyama E Biochem Biophys Res Commun. 2002;298:714–9.PubMedCrossRefGoogle Scholar
  54. Mason EE. Obes Surg. 1999;9:223–8.PubMedCrossRefGoogle Scholar
  55. Moo TA, Rubino F Curr Opin Endocrinol Diabetes Obes. 2008;15:53–8.CrossRefGoogle Scholar
  56. Naslund E, Backman L, Gryback P, Hellstrom PM, Holst JJ, Jacobsson H, Theodorsson E Int J Obes Relat Metab Disord. 1997;21:387–92.PubMedCrossRefGoogle Scholar
  57. Parks DJ, Blanchard SG, Bledsoe RK, Chandra G, Consler TG, Kliewer SA, Lehmann JM, Moore DD, Stimmel JB, Willson TM, Zavacki AM Science 1999;284:1365–8.PubMedCrossRefGoogle Scholar
  58. Patriti A, Donini A, Facchiano E Ann Surg. 2004a;240:388–9.PubMedCrossRefGoogle Scholar
  59. Patriti A, Donini A, Facchiano E, Gulla N, Sanna A Obes Surg. 2004b;14:840–8.PubMedCrossRefGoogle Scholar
  60. Patriti A, Annetti C, Aisa MC, Donini A, Facchiano E, Fanelli C, Galli F Obes Surg. 2005;15:1258–64.PubMedCrossRefGoogle Scholar
  61. Patriti A, Aisa MC, Annetti C, Donini A, Ferri I, Galli F, Gullà N, Sidoni A Surgery 2007;142:74–85.PubMedCrossRefGoogle Scholar
  62. Patti ME, Houten SM, Bianco AC, Bernier R, Larsen PR, Holst JJ, Badman MK, Maratos-Flier E, Mun EC, Pihlajamaki J, Auwerx J, Goldfine AB. Obesity 2009; Epub ahead of print.Google Scholar
  63. Plaisancié P, Chayvialle JA, Cuber JC, Dumoulin V J Endocrinol. 1996;151:421–9.PubMedCrossRefGoogle Scholar
  64. Pories WJ, Barakat HA, Brown BM, deRamon RA, Dolezal JM, Israel G, Long SB, MacDonald KG, Morris PG, Swanson MS Ann Surg. 1995;222:339–50.PubMedCrossRefGoogle Scholar
  65. Qiao L, Amorino G, Dent P, Engelhardt JF, Fang Y, Gilfor D, Grant S, Gupta S, Han SI, Hylemon PB, Park JS, Sealy L, Valerie K Mol Cell Biol. 2003;23:3052–66.PubMedCrossRefGoogle Scholar
  66. Rand CS, Hankins GC, Macgregor AM South Med J. 1987;80:961–4.PubMedCrossRefGoogle Scholar
  67. Saber AA, Elgamal MH, McLeod MK Obes Surg. 2008;18:121–8.PubMedCrossRefGoogle Scholar
  68. Schwartz MW, Morton GJ Nature 2002;418:595–7.PubMedCrossRefGoogle Scholar
  69. Shaham O, Carr SA, Gerszten RE, Lewis GD, Mootha VK, Ricciardi C, Thadhani R, Vasan RS, Wang TJ, Wei R Mol Syst Biol. 2008;4:214.PubMedCrossRefGoogle Scholar
  70. Soper NJ, Brown ML, Chapman NJ, Go VL, Kelly KA, Phillips SF Gastroenterology 1990;98:111–6.PubMedGoogle Scholar
  71. Stoeckli R, Chanda R, Keller U, Langer I Obes Res. 2004;12:346–50.PubMedCrossRefGoogle Scholar
  72. Strader AD, D’Alessio DA, Jandacek RJ, Seeley RJ, Vahl TP, Woods SC Am J Physiol Endocrinol Metab. 2005;288:E447–53.PubMedCrossRefGoogle Scholar
  73. Tadross JA, le Roux CW Int J Obes. 2009;33:S28–32.CrossRefGoogle Scholar
  74. Tomlinson E, French D, Fu L, Huang X, Hultgren B, John L, Powell-Braxton L, Renz M, Stephan JP, Stewart TA, Tsai SP Endocrinology 2002;143:1741–7.PubMedCrossRefGoogle Scholar
  75. Tritos NA, Bertkau A, Goldfine A, Grayson R, Maratos-Flier E, Mun E Obes Res. 2003;11:919–24.PubMedCrossRefGoogle Scholar
  76. Trostler N, Avinoach E, Charuzi II, Mann A, Zilberbush N Obes Surg. 1995;5:39–51.PubMedCrossRefGoogle Scholar
  77. Vendrell J, Broch M, Gómez JM, Gutiérrez C, Molina A, Richart C, Simón I, Soler J, Vilarrasa N Obes Res. 2004;12:962–71.PubMedCrossRefGoogle Scholar
  78. Vidal J, Casamitjana R, Gomis R, Moize V, Morinigo R Obes Res. 2003;11:A9.Google Scholar
  79. Vincent RP, le Roux CW Clin Endocrinol (Oxf). 2008;69:173–9.CrossRefGoogle Scholar
  80. Watanabe M, Auwerx J, Bianco AC, Christoffolete MA, Ezaki O, Harney JW, Houten SM, Kim BW, Kodama T, Mataki C, Messaddeq N, Sato H, Schoonjans K Nature 2006;439:484–9.PubMedCrossRefGoogle Scholar
  81. Wen J, Holst JJ, Kost LJ, Phillips SF, Sarr MG Am J Physiol Gastrointest Liver Physiol. 1995;269:G945–52.Google Scholar
  82. WHO. Obesity and overweight: fact sheet No 3111. 2006.http://www.who.int/mediacentre/factsheets/fs311/en/index.html.
  83. Yamagata K, Daitoku H, Fukamizu A, Hirota K, Ishida J, Matsuzaki H, Shimamoto Y J Biol Chem. 2004;279:23158–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Rachel E. Roberts
    • 1
  • Jamsaid Alaghband-Zadeh
  • Carel W. Le Roux
  1. 1.Discipline of Medicine, School of MedicineKing’s College LondonLondonUK

Personalised recommendations