Effects of bariatric and metabolic surgery on bile acid synthase activity, conjugation enzyme gene and intestinal mucosal barrier function (D-LA, Zonulin -E8) in diabetic patients

  • Jingjing Zhang State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Nephrology, The First Affiliated Hospital of Xinjiang Medical University
  • Shadike Apaer State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia,Department of Liver Transplantation & Laparoscopic Surgery, The First Affiliated Hospital of Xinjiang Medical University
  • Shuo Zhang State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia,Department of Liver Transplantation & Laparoscopic Surgery, The First Affiliated Hospital of Xinjiang Medical University
  • Guanyou Liang State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia,Department of Liver Transplantation & Laparoscopic Surgery, The First Affiliated Hospital of Xinjiang Medical University
  • Tao Li State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia,Department of Liver Transplantation & Laparoscopic Surgery, The First Affiliated Hospital of Xinjiang Medical University
  • Xinling Cao State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Liver Transplantation & Laparoscopic Surgery, the First Affiliated Hospital of Xinjiang Medical University
DOI: https://doi.org/10.5937/jomb0-58245
Keywords: bariatric and metabolic surgery, type 2 diabetes mellitus, bile acid synthase activity gene, bile acid conjugation enzyme gene

Abstract


Objective: To observe the changes of bile acid synthase activity, conjugation enzyme gene and intestinal mucosal barrier function (D-LA, Zonulin, MFG-E8) in patients with type 2 diabetes mellitus (T2DM) after bariatric and metabolic surgery (BMS), and to provide an objective opinion on the clinical optimization of BMS.

Methods: 127 patients with T2DM who had received BMS treatment at our hospital from October 2023 to August 2024 were included in the study, and weight loss, glucose-lipid metabolism was detected before surgery and at 6 months after surgery. Furthermore, the study quantified the expression levels of key enzymes involved in bile acid synthesis and conjugation (CYP7A1, CYP27A1, FXR, FGF19) and markers indicative of intestinal mucosal barrier function (D-LA, Zonulin, MFG-E8).

Results: After BMS, the patient's weight was significantly reduced and glucolipid metabolism was significantly improved (P<0.05). In addition, CYP7A1 was decreased and FXR, FGF19 was elevated in patients after surgery (P<0.05). Regarding the intestinal mucosal barrier function, D-LA, Zonulin were decreased in patients after surgery (P<0.05). MFG-E8 was not significantly altered after surgery in patients with sleeve gastrectomy (P>0.05), while it was elevated after surgery in patients with Roux-en-Y gastric bypass compared to baseline (P<0.05).

Conclusion: BMS can effectively improve glucose-lipid metabolism and reduce body weight in T2DM patients, and its mechanism is related to regulating bile acid metabolism and promoting the recovery of intestinal barrier function.

Published
2025/06/04
Issue
Ahead of print
Section
Original paper

Copyright (c) 2025 Jingjing Zhang, Shadike Apaer, Shuo Zhang, Guanyou Liang, Tao Li, Xinling Cao

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