Evidence map›Paper›PMID 39096744›Full record

ArticleEBioMedicine2024

Alterations in bile acid kinetics after bariatric surgery in patients with obesity with or without type 2 diabetes.

Annika Wahlström, Ömrüm Aydin, Lisa M Olsson, Wilhelm Sjöland, Marcus Henricsson, Annika Lundqvist, Hanns-Ulrich Marschall, Rutger Franken, Arnold van de Laar, Victor Gerdes and 6 more

Abstract read
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In one paragraph

Article in EBioMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
–field-weighted citation impact
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

22 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Review
  5. Abdominal Pain After Bariatric Surgery and the Role of the Gut: A Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
    Review
  6. Review
  7. Article
  8. Review
  9. Observational
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Review
  18. The role of the gut-brain axis in bariatric surgery.Current opinion in neurobiology · 2025
    Review
  19. Bile acid metabolism in type 2 diabetes mellitus.Nature reviews. Endocrinology · 2025
    Review
  20. 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

16 authors.

Annika WahlströmWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden.
Ömrüm AydinDepartment of Internal and Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Lisa M OlssonWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden.
Wilhelm SjölandWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden.
Marcus HenricssonWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden.
Annika LundqvistWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden.
Hanns-Ulrich MarschallWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden.
Rutger FrankenDepartment of Surgery, Spaarne Hospital, Hoofddorp, the Netherlands.
Arnold van de LaarDepartment of Surgery, Spaarne Hospital, Hoofddorp, the Netherlands.
Victor GerdesDepartment of Internal and Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
Abraham S MeijnikmanDepartment of Internal and Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
Dag HofsøDepartment of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway.
Albert K GroenExperimental Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
Jøran HjelmesæthDepartment of Endocrinology, Obesity and Nutrition, Vestfold Hospital Trust, Tønsberg, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Norway.
Max NieuwdorpDepartment of Internal and Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Experimental Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
Fredrik BäckhedWallenberg Laboratory and Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg S-413 45, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark; Region Västra Götaland, Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg, Sweden. Electronic address: Fredrik.Backhed@wlab.gu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBariatric surgery is an effective treatment option for obesity and provides long-term weight loss and positive effects on metabolism, but the underlying mechanisms are poorly understood. Alterations in bile acid metabolism have been suggested as a potential contributing factor, but comprehensive studies in humans are lacking.

methodsIn this study, we analysed the postprandial responses of bile acids, C4 and FGF19 in plasma, and excretion of bile acids in faeces, before and after bariatric surgery in patients (n = 38; 74% females) with obesity with or without type 2 diabetes from the BARIA cohort.

findingsWe observed that total fasting plasma bile acid levels increased, and faecal excretion of bile acids decreased after surgery suggesting increased reabsorption of bile acids. Consistent with increased bile acid levels after surgery we observed increased postprandial levels of FGF19 and suppression of the bile acid synthesis marker C4, suggesting increased FXR activation in the gut. We also noted that a subset of bile acids had altered postprandial responses before and after surgery. Finally, fasting plasma levels of 6α-hydroxylated bile acids, which are TGR5 agonists and associated with improved glucose metabolism, were increased after surgery and one of them, HDCA, covaried with diabetes remission in an independent cohort.

interpretationOur findings provide new insights regarding bile acid kinetics and suggest that bariatric surgery in humans alters bile acid profiles leading to activation of FXR and TGR5, which may contribute to weight loss, improvements in glucose metabolism, and diabetes remission.

fundingNovo Nordisk Fonden, Leducq Foundation, Swedish Heart-Lung Foundation, Knut and Alice Wallenberg Foundation, the ALF-agreement, ZonMw.

Indexed as

Bariatric SurgeryBile Acids and SaltsDiabetes Mellitus, Type 2Fibroblast Growth FactorsObesityAdultBiomarkersFastingFecesFemaleHumansKineticsMaleMiddle AgedPostprandial PeriodBile Acids and SaltsBiomarkersFGF19 protein, humanFibroblast Growth Factors6α-hydroxylated bile acidsDiabetes remissionPostprandial responseRoux-en-Y gastric bypass

Identifiers

PMID39096744
PMCPMC11345581

What Socratic holds

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Registered trials

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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.