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Metabolic Effects of Bile Acids: Potential Role in Bariatric Surgery

dc.contributor.authorFlynn, Charles R
dc.contributor.authorAlbaugh, Vance L.
dc.contributor.authorAbumrad, Naji N.
dc.description.abstractBariatric surgery is the most effective and durable treatment for morbid obesity, with an unexplained yet beneficial side effect of restoring insulin sensitivity and improving glycemia, often before weight loss is observed. Among the many contributing mechanisms often cited, the altered handling of intestinal bile acids is of considerable therapeutic interest. Here, we review a growing body of literature examining the metabolic effects of bile acids ranging from their physical roles in dietary fat handling within the intestine to their functions as endocrine and paracrine hormones in potentiating responses to bariatric surgery. The roles of 2 important bile acid receptors, Takeda G-protein coupled receptor (also known as G-protein coupled bile acid receptor) and farnesoid X receptor, are highlighted as is downstream signaling through glucagon-like polypeptide 1 and its cognate receptor. Additional improvements in other phenotypes and potential contributions of commensal gut bacteria, such as Akkermansia muciniphila, which are manifest after Rouxen-Y gastric bypass and other emulations, such as gallbladder bile diversion to the ileum, are also discussed.en_US
dc.description.sponsorshipSupported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, specifically grants DK059637 (Vanderbilt Mouse Metabolic Phenotyping Center), DK020593 (Vanderbilt Diabetes Research and Training Center), DK058404 (Vanderbilt Digestive Disease Research Center), F32 DK103474 (V.L.A.), and R01 DK105847 (N.N.A. and C.R.F.). This work was also supported by a Research Grant from the Society of American Gastrointestinal and Endoscopic Surgeons (V.L.A.).en_US
dc.publisherCellular and Molecular Gastroenterology and Hepatologyen_US
dc.rights© 2019 The Authors. Published by Elsevier Inc. on behalf of the AGA Institute. This is an open access article under the CC BY-NC-ND license (
dc.subjectBariatric Surgeryen_US
dc.subjectBile Acidsen_US
dc.subjectType 2 Diabetesen_US
dc.subjectRouxen Y Gastric Bypassen_US
dc.subjectGlucagon-Like Polypeptide 1 (GLP-1)en_US
dc.titleMetabolic Effects of Bile Acids: Potential Role in Bariatric Surgeryen_US

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