Evidence map›Paper›PMID 33452416›Full record

ArticleInternational journal of obesity (2005)2021

Altered bile acid kinetics contribute to postprandial hypoglycaemia after Roux-en-Y gastric bypass surgery.

Merel van den Broek, Loek J M de Heide, Fianne L P Sips, Martijn Koehorst, Tim van Zutphen, Marloes Emous, Martijn van Faassen, Albert K Groen, Natal A W van Riel, Jan F de Boer and 2 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of obesity (2005), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
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  18. Postbariatric hypoglycemia: symptom patterns and associated risk factors in the Longitudinal Assessment of Bariatric Surgery study.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2021
    Article
  19. Article
  20. Bile acids and metabolic surgery.Liver research (Beijing, China) · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Merel van den BroekCenter for Obesity North Netherlands (CON), Department of Surgery, MCL, Leeuwarden, The Netherlands.
Loek J M de HeideCenter for Obesity North Netherlands (CON), Department of Surgery, MCL, Leeuwarden, The Netherlands.
Fianne L P SipsDepartment of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Martijn KoehorstDepartment of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Tim van ZutphenFaculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
Marloes EmousCenter for Obesity North Netherlands (CON), Department of Surgery, MCL, Leeuwarden, The Netherlands.
Martijn van FaassenDepartment of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Albert K GroenDepartment of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Natal A W van RielDepartment of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.ORCID http://orcid.org/0000-0001-9375-4730
Jan F de BoerDepartment of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
André P van BeekCenter for Obesity North Netherlands (CON), Department of Surgery, MCL, Leeuwarden, The Netherlands.
Folkert KuipersDepartment of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. f.kuipers@umcg.nl.ORCID http://orcid.org/0000-0003-2518-737X
University Medical Center Groningen · NLAmsterdam University Medical Centers · NLEindhoven University of Technology · NLUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesBile acids (BA) act as detergents in intestinal fat absorption and as modulators of metabolic processes via activation of receptors such as FXR and TGR5. Elevated plasma BA as well as increased intestinal BA signalling to promote GLP-1 release have been implicated in beneficial health effects of Roux-en-Y gastric bypass surgery (RYGB). Whether BA also contribute to the postprandial hypoglycaemia that is frequently observed post-RYGB is unknown.

methodsPlasma BA, fibroblast growth factor 19 (FGF19), 7α-hydroxy-4-cholesten-3-one (C4), GLP-1, insulin and glucose levels were determined during 3.5 h mixed-meal tolerance tests (MMTT) in subjects after RYGB, either with (RYGB, n = 11) or without a functioning gallbladder due to cholecystectomy (RYGB-CC, n = 11). Basal values were compared to those of age, BMI and sex-matched obese controls without RYGB (n = 22).

resultsFasting BA as well as FGF19 levels were elevated in RYGB and RYGB-CC subjects compared to non-bariatric controls, without significant differences between RYGB and RYGB-CC. Postprandial hypoglycaemia was observed in 8/11 RYGB-CC and only in 3/11 RYGB. Subjects who developed hypoglycaemia showed higher postprandial BA levels coinciding with augmented GLP-1 and insulin responses during the MMTT. The nadir of plasma glucose concentrations after meals showed a negative relationship with postprandial BA peaks. Plasma C4 was lower during MMTT in subjects experiencing hypoglycaemia, indicating lower hepatic BA synthesis. Computer simulations revealed that altered intestinal transit underlies the occurrence of exaggerated postprandial BA responses in hypoglycaemic subjects.

conclusionAltered BA kinetics upon ingestion of a meal, as frequently observed in RYGB-CC subjects, appear to contribute to postprandial hypoglycaemia by stimulating intestinal GLP-1 release.

Indexed as

Gastric BypassAdultBile Acids and SaltsCase-Control StudiesFemaleHumansHypoglycemiaKineticsMaleMiddle AgedObesityPostprandial PeriodBile Acids and Salts

Identifiers

PMID33452416
PMCPMC7906904
OpenAlexW3124078880

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.