Abstract
Background and Objective: In obese patients, sleeve gastrectomy (SG) has shown mixed results on bile acid (BA) values. The aim of our study was to examine the potential ultra-early and early changes of the circulating total BA in relation with the changes of insulin resistance (IR) in obese patients submitted to laparoscopic SG. Materials and Methods: Twenty-four obese subjects were investigated for body mass index (BMI), total fasting BA, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and leptin before and at 7 and 30 d after SG. Results: After surgery, mean BMI decreased at the first (p < 0.001) and at the second time point (p < 0.001) relative to baseline. Total fasting BA values did not change significantly at 7 d (p = 0.938) and at 30 d (p = 0.289) after SG. No significant changes were found at 7 d (p = 0.194, p = 0.34) and 30 d (p = 0.329, p = 0.151) after surgery regarding fasting insulin and HOMA-IR, respectively. However, a trend of increased total fasting BA and decreased fasting insulin and HOMA- after laparoscopic SG has been found. Negative correlations between total fasting BA and insulin (r = −0.807, p = 0.009), HOMA-IR (r = −0.855, p = 0.014), and blood glucose (r = −0.761, p = 0.047), respectively, were observed at one month after SG. Conclusion: In conclusion, here, we found a lack of significant changes in total fasting BA, insulin, and HOMA-IR ultra-early and early after SG, which precluded us to consider a possible relation between the variations of BA and IR. However, the presence of the tendency for total fasting BA to increase and for insulin and HOMA-IR to decrease, as well as of the negative correlations one month after laparoscopic SG, suggest that this surgery brings about some changes that point towards the existence, and possibly towards the restoration, at least to some extent, of the link between BA and glucose metabolism.
Highlights
Obesity has increased worldwide at an alarming rate [1]
Estimated mean reductions of 10.71 ng/mL at 7 d and of 6.81 ng/mL at 30 d after laparoscopic sleeve gastrectomy (SG) were detected for leptin (Table 1)
We did notice a different distribution of fasting insulin and HOMA-insulin resistance (IR) values at baseline as compared to both postsurgical follow up time points, we found no statistical differences by the
Summary
Obesity has increased worldwide at an alarming rate [1]. Beyond the excess of fat mass, obese people display a gamut of disturbances such as type 2 diabetes mellitus (T2DM), dyslipidemia, and hypertension that impair health and reduce lifespan [2]. Apart from weight reduction, the various procedures of bariatric surgery have proven to be beneficial in inducing important metabolic and hormonal effects, out of which, noteworthily, some seem to be independent of the amount of fat loss [7,8,9]. In this respect, the resolution of IR and T2DM are often observed as early as a few days after bariatric surgery, suggesting that these improvements do not go in parallel with the gradual changes in body weight [7,10,11].
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