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Carel Le Roux (Imperial College, UK. Diabetes Complications Research Center, Dublin, Ireland) explains in this IFSO lecture the importance of the bile acids on the metabolic signaling function.
He reviews the current literature on the effect of bile acids on the liver, enterocytes, intestinal L cells, adipocytes and muscle.
He stresses the relation between the shift in the gut microbiome and bile acids in the lumen of the small bowel after gastric bypass and vertical banded gastroplasty.
To summarize, bile acids have effects on:
- Brown adipose tissue and muscle: increasing energy expenditure.
- ß-cells: increasing insulin.
- Intestinal L-cells: increasing GLP-1.
- Intestinal enterocyte: secreting FGF19
- Liver: due to the secretion of FGF19 by the enterocyte, decreasing gluconeogenesis, increasing glycogen synthesis and increasing protein synthesis.
- Adipocyte: increasing glucose intake.
Bile acids should be considered a new gut hormone, not only with a digestive function but also with an important metabolic signaling function. This is important in operations such as gastric bypass, in which this mechanism could help to understand weight loss, weight loss maintenance, and the improvement in glycemic control.
