Page 112 - Human Bile Acid Metabolism: a Postprandial Perspective

Chapter 6
between 2 test conditions were made with Wilcoxon matched pairs signed rank testing. Correlations were assessed using Pearson’s correlation for normally distributed populations or Spearman’s Rho for other data. A p-value of 0.05 was considered statistically significant after Bonferroni corrections. Data presented are mean and standard deviation (μ ± σ) for normally distributed variables or median and interquartile range (m [IQR]) for other variables. Graphs were made using GraphPad Prism 6.0 (GraphPad Software Inc., La Jolla, CA, USA).
Results
Lining of the Proximal Small Intestine by DJBL Reduces Body Weight
The weight loss effects of the DJBL have been published previously [17]. At baseline, subjects (14 males, 3 females) were 51 ± 2 years old and weighed 116.0 ± 5.8 kg with a BMI of 37.0 ± 1.3 kg/m2. One week after placement of the DJBL, body weight had decreased by 4.3 ± 0.6 kg, corresponding to an excess weight loss of 10.2 ± 1.7% and a BMI reduction of 1.4 ± 0.2 kg/m2 (p < 0.01). After 24 weeks, at the time of device removal, mean body weight had further decreased resulting in a total weight loss of 12.7 ± 1.3 kg, and a BMI reduction of 4.1 ± 0.4 kg/m2 (p < 0.01). All subjects reported lowered caloric intake during the study and 88% of the subjects (15/17) reported increased feelings of satiety.
Lining of the Proximal Small Intestine by DJBL Increases Fasting
and Postprandial Unconjugated Bile Acid Levels
All subjects completed the study. AUC, fasting and peak levels of total bile acids and all bile acid subsets except UDCA were markedly increased 24 weeks after placement but not after 1 week (see Fig. 1 and Table 1). In fact, the increase of AUCs relied primarily on the increase in fasting plasma bile acids since incremental AUCs were unaffected by DJBL placement (data not shown). Peak times (time from start of the meal to the peak of the plasma bile acids) were unchanged for all bile acids and bile acid subfractions (data not shown).
The Increase in Plasma Bile Acids by DJBL is Completely Caused
by Unconjugated Bile Acids
To gain further insight in the composition of the bile acid pool after overnight fasting, we analysed the different bile acids species as well as the conjugation status.
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