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Bile Acids, FXR, and Metabolic Effects of Bariatric Surgery


Affiliations
1 Temple University School of Medicine, Philadelphia, PA 19140, United States
2 Geisinger Clinic, Danville, PA 17822, United States
 

Overweight and obesity represent major risk factors for diabetes and related metabolic diseases. Obesity is associated with a chronic and progressive inflammatory response leading to the development of insulin resistance and type 2 diabetes (T2D) mellitus, although the precise mechanism mediating this inflammatory process remains poorly understood.The most effective intervention for the treatment of obesity, bariatric surgery, leads to glucose normalization and remission of T2D. Recent work in both clinical studies and animal models supports bile acids (BAs) as key mediators of these effects. BAs are involved in lipid and glucose homeostasis primarily via the farnesoid X receptor (FXR) transcription factor. BAs are also involved in regulating genes involved in inflammation, obesity, and lipid metabolism. Here, we review the novel role of BAs in bariatric surgery and the intersection between BAs and immune, obesity, weight loss, and lipid metabolism genes.
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  • Bile Acids, FXR, and Metabolic Effects of Bariatric Surgery

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Authors

Olivier F. Noel
Temple University School of Medicine, Philadelphia, PA 19140, United States
Christopher D. Still
Geisinger Clinic, Danville, PA 17822, United States
George Argyropoulos
Geisinger Clinic, Danville, PA 17822, United States
Michael Edwards
Temple University School of Medicine, Philadelphia, PA 19140, United States
Glenn S. Gerhard
Temple University School of Medicine, Philadelphia, PA 19140, United States

Abstract


Overweight and obesity represent major risk factors for diabetes and related metabolic diseases. Obesity is associated with a chronic and progressive inflammatory response leading to the development of insulin resistance and type 2 diabetes (T2D) mellitus, although the precise mechanism mediating this inflammatory process remains poorly understood.The most effective intervention for the treatment of obesity, bariatric surgery, leads to glucose normalization and remission of T2D. Recent work in both clinical studies and animal models supports bile acids (BAs) as key mediators of these effects. BAs are involved in lipid and glucose homeostasis primarily via the farnesoid X receptor (FXR) transcription factor. BAs are also involved in regulating genes involved in inflammation, obesity, and lipid metabolism. Here, we review the novel role of BAs in bariatric surgery and the intersection between BAs and immune, obesity, weight loss, and lipid metabolism genes.