Fecal bile acid profile after Roux-en-Y gastric bypass and its association with the remission of type 2 diabetes in obese women: A preliminary study

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2019-12, Vol.38 (6), p.2906-2912
• Main Authors: de Siqueira Cardinelli, Camila, Torrinhas, Raquel Susana, Sala, Priscila, Pudenzi, Marcos Albieri, Fernando F Angolini, Célio, Marques da Silva, Mariane, Machado, Natasha Mendonça, Ravacci, Graziela, Eberlin, Marcos N., Waitzberg, Dan L.
• Format: Article
• Language: English
• Subjects: Bariatric surgery; Fecal bile acids; Type 2 diabetes
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2018.12.028

To assess the influence of Roux-en-Y gastric by-pass (RYGB) on fecal bile acid (BA) profile and its relationship with postoperative remission of type 2 diabetes (T2D). Fecal samples were collected 3 and 12 months after RYGB from diabetic obese women who were responsive (n = 12) and non-responsive (n = 8) to postoperative remission of T2D. Fecal BA profile was accessed by liquid chromatography coupled to tandem mass spectrometry in a targeted approach. Relative to pre-operative levels, a total of 10 fecal BA profiles decreased after RYGB (ANOVA, p ≤ 0.05) with significant fold-changes for glycochenodeoxycholic, glycocholic, taurocholic, and taurochenodeoxycholic acids at 3-months postoperatively, and for glycochenodeoxycholic, glycocholic and taurocholic acids at 12 months postoperatively (Benjamini–Hochberg, p ≤ 0.05). Postoperative changes in fecal BA were different between responsive and non-responsive women, with a significant reduction in more sub-fractions of BA in responsive women than in non-responsive women, and a marked difference in the temporal behavior of cholic acid (CA) and chenodeoxycholic acid (CDCA), thus reflecting changes in CA/CDCA ratio, and tauroursodeoxycolic (TUDCA) levels between these responsiveness groups (ANOVA, p ≤ 0.05). RYGB induces a marked reduction in the concentration of fecal BA, which is heterogeneous according to T2D responsiveness. •Fecal BA profile can reflect crosstalk between gut microbiota and circulating BA.•Fecal BA profiles of obese women with T2D changed early after RYGB and persisted for 1-year postoperatively.•Reductions in fecal BA sub-fractions differed between women that achieved, or did not achieve, the remission of T2D.•Temporal changes in fecal CA/CDCA and TUDCA were able to distinguish patients with postoperative remission of T2D.