PMID- 31181641 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200930 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 8 IP - 6 DP - 2019 Jun 7 TI - Bile Acid and Fibroblast Growth Factor 19 Regulation in Obese Diabetics, and Non-Alcoholic Fatty Liver Disease after Sleeve Gastrectomy. LID - 10.3390/jcm8060815 [doi] LID - 815 AB - BACKGROUND: Sleeve gastrectomy (SG) is an effective treatment for obesity and type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD); however, the mechanism is not completely understood. Bile acids and fibroblast growth factors (FGFs) are involved in the regulation of energy metabolism. METHODS: We investigated the roles of total bile acid and FGF 19 in T2DM remission and NAFLD improvement in obese subjects undergoing SG. A total of 18 patients with obesity and T2DM undergoing laparoscopic SG were enrolled in this study. Serial plasma total bile acid and FGF 19 levels were measured, while the fatty liver index was calculated before and after surgery. RESULTS: The FGF 19 level significantly increased, and the total bile acid level and fatty liver index decreased 1 year after surgery. The complete T2DM remission rate was 66.7% one year after surgery; the complete remitters had significantly lower FGF 19 levels and higher insulin levels than the non-complete remitters. The complete remitters also had significantly decreased total bile acid levels and increased FGF 19 levels 1 year after surgery compared with those before surgery. The fatty improvers had significantly decreased total bile acid levels and increased FGF 19 levels 1 year after surgery compared with those before surgery. CONCLUSION: The total bile acids level and fatty liver index decreased, and the FGF 19 levels increased 1 year after SG. Both T2DM complete remitters and NAFLD improvers showed significantly decreased total bile acid levels and increased FGF 19 levels 1 year after SG. Plasma total bile acids and FGF 19 might have roles in T2DM remission and NAFLD improvement. Low preoperative FGF 19 levels might be a predictor for NAFLD improvement after SG. FAU - Huang, Hsien-Hao AU - Huang HH AD - Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan. hhhuang@vghtpe.gov.tw. AD - Institute of Emergency and Critical Medicine, National Yang-Ming University School of Medicine, Taipei 11221, Taiwan. hhhuang@vghtpe.gov.tw. FAU - Lee, Wei-Jei AU - Lee WJ AD - Department of Surgery, Min-Sheng General Hospital, Taoyuan 33044, Taiwan. wjlee_obessurg_tw@yahoo.com.tw. AD - Taiwan Society for Metabolic and Bariatric Surgery, Taipei 11031, Taiwan. wjlee_obessurg_tw@yahoo.com.tw. FAU - Chen, Shu-Chun AU - Chen SC AD - Taiwan Society for Metabolic and Bariatric Surgery, Taipei 11031, Taiwan. N002916@e-ms.com.tw. AD - Department of Nursing, Chang-Gung Institute of Technology, Taoyuan 33303, Taiwan. N002916@e-ms.com.tw. AD - Medical Affairs Office, Taipei City Hospital Yangming Branch, Taipei 11146, Taiwan. N002916@e-ms.com.tw. FAU - Chen, Tung-Fang AU - Chen TF AD - Medical Affairs Office, Taipei City Hospital Yangming Branch, Taipei 11146, Taiwan. Z4430@tpech.gov.tw. FAU - Lee, Shou-Dong AU - Lee SD AD - Division of Gastroenterology, Department of Internal Medicine, Cheng-Hsin General Hospital, Taipei 11220, Taiwan. ch9318@chgh.org.tw. FAU - Chen, Chih-Yen AU - Chen CY AD - Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan. chency@vghtpe.gov.tw. AD - Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei 11221, Taiwan. chency@vghtpe.gov.tw. AD - Chinese Taipei Society for the Study of Obesity, Taipei 11031, Taiwan. chency@vghtpe.gov.tw. LA - eng GR - MOST 104-2314-B-010-005-/Ministry of Science and Technology, Taiwan/ GR - V104C-112, V105C-103, and V106C-123/Taipei Veterans General Hospital/ GR - 103F003C13/Cheng Hsin General Hospital, and the National Yang-Ming University Joint Research Program/ PT - Journal Article DEP - 20190607 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC6616896 OTO - NOTNLM OT - FGF 19 OT - diabetes mellitus OT - non-alcoholic fatty liver disease OT - sleeve gastrectomy OT - total bile acid COIS- The authors report no conflicts of interest in this work. EDAT- 2019/06/12 06:00 MHDA- 2019/06/12 06:01 PMCR- 2019/06/07 CRDT- 2019/06/12 06:00 PHST- 2019/05/09 00:00 [received] PHST- 2019/05/26 00:00 [revised] PHST- 2019/06/04 00:00 [accepted] PHST- 2019/06/12 06:00 [entrez] PHST- 2019/06/12 06:00 [pubmed] PHST- 2019/06/12 06:01 [medline] PHST- 2019/06/07 00:00 [pmc-release] AID - jcm8060815 [pii] AID - jcm-08-00815 [pii] AID - 10.3390/jcm8060815 [doi] PST - epublish SO - J Clin Med. 2019 Jun 7;8(6):815. doi: 10.3390/jcm8060815.