Bile acids and bariatric surgery

Albaugh, Vance L.; Banan, Babak; Ajouz, Hana; Abumrad, Naji N.; Flynn, Charles R.

doi:10.1016/j.mam.2017.04.001

Cited by 148Bariatric Surgery and OutcomesGut microbiota and healthDrug Transport and Resistance Mechanisms

Bile acids and bariatric surgery

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Albaugh, Vance L., Banan, Babak, Ajouz, Hana, Abumrad, Naji N., Flynn, Charles R.·2017·Molecular Aspects of Medicine

DOI 10.1016/j.mam.2017.04.001PMC PMC5603298

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Abstract

Bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), are the most effective and durable treatments for morbid obesity and potentially a viable treatment for type 2 diabetes (T2D). The resolution rate of T2D following these procedures is between 40 and 80% and far surpasses that achieved by medical management alone. The molecular basis for this improvement is not entirely understood, but has been attributed in part to the altered enterohepatic circulation of bile acids. In this review we highlight how bile acids potentially contribute to improved lipid and glucose homeostasis, insulin sensitivity and energy expenditure after these procedures. The impact of altered bile acid levels in enterohepatic circulation is also associated with changes in gut microflora, which may further contribute to some of these beneficial effects. We highlight the beneficial effects of experimental surgical procedures in rodents that alter bile secretory flow without gastric restriction or altering nutrient flow. This information suggests a role for bile acids beyond dietary fat emulsification in altering whole body glucose and lipid metabolism strongly, and also suggests emerging roles for the activation of the bile acid receptors farnesoid x receptor (FXR) and G-protein coupled bile acid receptor (TGR5) in these improvements. The limitations of rodent studies and the current state of our understanding is reviewed and the potential effects of bile acids mediating the short- and long-term metabolic improvements after bariatric surgery is critically examined.

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The concept of combining entero-pancreatic hormones for obesity treatment was supported by the marked weight loss, sustained weight maintenance, and metabolic benefits observed with bariatric surgery, which increase multiple gut hormone levels.
“Looking for the next step in obesity pharmacotherapies, the concept of combining entero-pancreatic hormones for obesity treatment was supported by the marked WL, sustained weight maintenance, and metabolic benefits observed with BS, which increase multiple gut hormone levels [9–14].”
From Triple Agonism Based Therapies for Obesity (2025) · cites this paper as [14]
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Abumrad NN Breitman I Wattacheril J Hubbard WJ Chaudry IH 2012 Metabolic and Inflammatory Responses to Trauma and Infection Fischers Mastery of Surgery Lippincott Williams & Wilkins 1 49
Ma K Saha PK Chan L Moore DD 2006b Farnesoid X receptor is essential for normal glucose homeostasis J Clin Invest 116 1102 1109 10.1172/JCI25604 16557297 PMC1409738 · DOI

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Authors: Albaugh, V. L., Banan, B., Ajouz, H., Abumrad, N. N., & Flynn, C. R.
Affiliations: Vanderbilt University Medical Center (US)
American University of Beirut (LB)
Corresponding author: Flynn, Charles R.
ORCID: Albaugh, Vance L.
Banan, Babak
Abumrad, Naji N.
Flynn, Charles R.
Venue: Molecular Aspects of Medicine
Publisher: Elsevier BV
Published: 2017-08
Volume: 56
Pages: 75-89
ISSN: 0098-2997 (ISSN-L)
DOI: 10.1016/j.mam.2017.04.001
PMC: PMC5603298
OpenAlex: W2607504605
Cited by: 148
References: 256
Citations by year: 2026: 12 · 2025: 16 · 2024: 19 · 2023: 17 · 2022: 17 · 2021: 15 · 2020: 19 · 2019: 12 · 2018: 10 · 2017: 11
FWCI: 3.01
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Molecular Aspects of Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (R01DK091748, R01DK070860, R01DK105847, F32DK103474)
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
Keywords: bile acids, bariatric surgery, Roux-en-Y gastric bypass, sleeve gastrectomy, morbid obesity, type 2 diabetes, enterohepatic circulation, gut microbiota, insulin sensitivity, glucose homeostasis, lipid homeostasis, energy expenditure, farnesoid X receptor, TGR5, bile acid receptors, rodent models
MeSH terms: Gastrointestinal Microbiome, Receptor, Farnesoid X-Activated, Animals, Bile Acids and Salts, Diabetes Mellitus, Type 2, Enterohepatic Circulation, Gastrectomy, Gene Expression Regulation, Glucose, Homeostasis, Humans, Insulin Resistance, Obesity, Morbid, Rodentia, Gastric Bypass, Signal Transduction, Receptors, Cytoplasmic and Nuclear, Receptors, G-Protein-Coupled

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