Effects of acute dietary weight loss on postprandial plasma bile acid responses in obese insulin resistant subjects

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 36; no. 6; pp. 1615 - 1620
• Main Authors: van Nierop, F. Samuel, Kulik, W., Endert, Erik, Schaap, Frank G., Olde Damink, Steven W., Romijn, Johannes A., Soeters, Maarten R.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2017
• Subjects: Adolescent; Adult; Bile acids; Bile Acids and Salts - blood; Blood Glucose - metabolism; Body Mass Index; Caloric Restriction; deoxycholic acid; Diabetes Mellitus, Type 2 - blood; Diet; Female; FGF19; fibroblast growth factors; Fibroblast Growth Factors - blood; Gastroenterology and Hepatology; glucose; Humans; insulin; Insulin - blood; Insulin Resistance; lipid metabolism; Male; Meals; Middle Aged; Mixed meal test; noninsulin-dependent diabetes mellitus; Obesity; Obesity - blood; Obesity - diet therapy; patients; Postprandial Period; receptors; resting energy expenditure; Type 2 diabetes; very low calorie diet; Weight Loss; Young Adult; Type 2 diabetes; CDCA; Obesity; Bile acids; DCA; FGF19; Mixed meal test; CA; BA; cholic acid; bile acid; chenodexocholic acid; deoxycholic acid
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2016.10.006

Bile acids (BA) are pleiotropic hormones affecting glucose and lipid metabolism. The physiochemical properties of different BA species affect their enterohepatic dynamics and their affinity for bile acid receptors. The BA pool composition is altered in patients with type 2 diabetes and obesity. In this study we used a 2-week very-low-calorie diet (VLCD) to investigate the effects of weight loss on BA pool composition and postprandial dynamics. We performed mixed meal tests in obese, insulin resistant subjects before and after the VLCD. We measured postprandial plasma levels of glucose, insulin, BA and the BA-induced enterokine fibroblast growth factor 19 (FGF19). The VLCD decreased weight by 4.5 ± 2.3 kg (p < 0.0001) within 14 days. Weight loss increased peak postprandial deoxycholate (DCA) levels (median [IQR]: 0.90 [0.90] vs. 1.25 [1.35] μmol/L; p = 0.045*). Other BA species, glucose, insulin and FGF19 levels and prandial excursions were not significantly affected. The VLCD decreased resting and postprandial energy expenditure by 7 and 11% respectively. VLCD induced weight loss increased postprandial DCA peak levels and decreased resting energy expenditure in obese insulin resistant subjects.