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Publication
Bile diversion to the distal small intestine has comparable metabolic benefits
to bariatric surgery.
Authors Flynn CR, Albaugh VL, Cai S, Cheung-Flynn J, Williams PE, Brucker RM,
Bordenstein SR, Guo Y, Wasserman DH, Abumrad NN
Submitted By Submitted Externally on 10/1/2015
Status Published
Journal Nature communications
Year 2015
Date Published
Volume : Pages 6 : 7715
PubMed Reference 26197299
Abstract Roux-en-Y gastric bypass (RYGB) is highly effective in reversing obesity and
associated diabetes. Recent observations in humans suggest a contributing role
of increased circulating bile acids in mediating such effects. Here we use a
diet-induced obesity (DIO) mouse model and compare metabolic remission when bile
flow is diverted through a gallbladder anastomosis to jejunum, ileum or duodenum
(sham control). We find that only bile diversion to the ileum results in
physiologic changes similar to RYGB, including sustained improvements in weight,
glucose tolerance and hepatic steatosis despite differential effects on hepatic
gene expression. Circulating free fatty acids and triglycerides decrease while
bile acids increase, particularly conjugated tauro-ß-muricholic acid, an FXR
antagonist. Activity of the hepatic FXR/FGF15 signalling axis is reduced and
associated with altered gut microbiota. Thus bile diversion, independent of
surgical rearrangement of the gastrointestinal tract, imparts significant weight
loss accompanied by improved glucose and lipid homeostasis that are hallmarks of
RYGB.




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