| Objective : To study the possible mechan[ism of bile acids(BAS)changes in relieving insulin resistance(IR)after laparoscopic sleeve gastrectomy(LSG)in obese patients.Methods: Collection of preoperative and postoperative body mass index(BMI),fasting blood glucose(FBG),fasting insulin(FINS),C-peptide,glycosylated hemoglobin(Hb A1C),bile acids(BAs)and fibroblast growth factorl9(FGFl9)in 60 obese patients received LSG from December 2017 to February 2020 in the Department of Weight Loss and Metabolism in the Second Hospital of Anhui Medical University.To explore the improvement of IR after LSG and its possible mechanism.Results : This study included 60 obese patients,30 obese patients with IR,30 obesity with type 2 diabetes mellitus(T2DM).One month after operation,C-peptide,FINS and HOMA-IR were significantly improved in all obese patients(P<0.05).In addition,FBG and Hb A1 c were also significantly improved in T2 DM group(P<0.05);At 12 months postoperatively,the levels of cholic acid(CA)decreased(P<0.05),total bile acids(TBA),chenodeoxycholic acid(CDCA),deoxycholic acid(DCA),lithocho1 ic acid(LCA)increased significantly(P<0.05),FGFl9 increased(P<0.05),and positively correlated with endogenous bile acid(P<0.05),negatively correlated with IR(P<0.05).Conclusion: LSG may directly improve insulin resistance by increasing the level of bile acid,or improve insulin resistance in obese patients by promoting the secretion of FGF19,which will provide a new idea for the treatment of IR in obese patients. |
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