Biliary Jejunostomy Might Improve Glucose in Type 2 Diabetes Patients

Zhang, Ning; Chen, Weijie; Yin, Haixin; Liu, Wei; He, Xiaodong

doi:10.1007/s11695-019-04319-z

Cited by 2 publications

(7 citation statements)

References 24 publications

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“…This system is known as enterohepatic circulation 18 . Studies have shown that the TBA level increased remarkably after biliary diversion in mice and human 9,12 , probably due to the higher expression of 7‐α hydroxylase 19 . Some kinds of the component in TBA might play a key role in metabolic changes, such as chenodeoxycholic acid, which was reported to be the most effective signaling molecular for activation of BAT 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Biliopancreatic diversion, which diverts the bile and pancreatic juice to the distal small intestine, is commonly recognized as the most effective procedure to improve diabetes 8 . Our previous study showed mere biliary diversion (BD) of biliary jejunostomy also improves glucose in type 2 diabetes mellitus patients 9 , and indicated the possible role of increased bile acids (BAs) after surgery; however, the mechanism among them is still not clear.…”

Section: Introductionmentioning

confidence: 99%

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Biliary diversion increases resting energy expenditure leading to decreased blood glucose level in mice with type 2 diabetes

Yin

Chen

Dong

et al. 2021

J of Diabetes Invest

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Aims/Introduction Type 2 diabetes mellitus is a group of metabolism abnormalities in carbohydrates and energy. Our aim was to investigate resting energy expenditure (REE) and blood glucose changes after biliary diversion in mice with diabetes. Materials and Methods Male mice with diabetes were randomly divided into biliary diversion and sham groups. REE was detected by indirect calorimetry, the levels of fasting blood glucose, total bile acids and triiodothyronine were analyzed. After mice were killed, the weight amount of brown adipose tissue (BAT) and gastrocnemius was measured, and the expression level of G protein‐coupled bile acid receptor and type 2 iodothyronine deiodinase in BAT and gastrocnemius were examined. Results The two groups of mice were pair‐fed, the bodyweights (P < 0.001) and the fasting blood glucose level (P < 0.001) in the biliary diversion group significantly decreased 24 weeks after surgery. The intraperitoneal glucose tolerance test (P = 0.035) and oral glucose tolerance test (P = 0.027) showed improvement in glucose tolerance after surgery. The REE level significantly increased 24 weeks after surgery (P = 0.005), the levels of total bile acids (P = 0.014) and triiodothyronine (P < 0.001) increased at the 24th postoperative week. The weight ratio of BAT (P = 0.038) and gastrocnemius (P = 0.026) in the biliary diversion group were higher than that in the sham group. The expression of G protein‐coupled bile acid receptor in BAT (P < 0.001) and gastrocnemius (P = 0.003) were upregulated after surgery, and the type 2 iodothyronine deiodinase expression also increased in BAT (P = 0.015) and gastrocnemius (P = 0.015). Conclusions The REE level increased and the glucose metabolism improved in mice with diabetes after biliary diversion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biliary diversion increases resting energy expenditure leading to decreased blood glucose level in mice with type 2 diabetes

Yin

Chen

Dong

et al. 2021

J of Diabetes Invest

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“…Glucose metabolism changes were assessed by the HbA1c level, FPG level and previously published definitions. [ 4 , 10 ] T2DM patients who were not taking any antidiabetic medication, had an HbA1c level of less than 6.5%, and had an FPG level of less than 7.0 mmol/L were considered “in remission.” Patients with no increase in HbA1c level and decreased FPG level were considered “improved.” Patients with an increased HbA1c level and decreased FBG level were considered “unimproved.” Patients with an increased HbA1c level and increased FBG level were considered “deteriorated.”…”

Section: Methodsmentioning

confidence: 99%

“…[ 3 ] The BA level increases significantly after metabolic surgery, and high levels of BAs might improve glucose metabolism in T2DM patients. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

“…[3] The BA level increases significantly after metabolic surgery, and high levels of BAs might improve glucose metabolism in T2DM patients. [4] Danning tablets (DNTs) are a composite prescription of traditional Chinese medicine, [5] and they comprise extracts of many medicinal materials, including Rheum officinale Baill (46.4 mg/tablet), Polygonum cuspidatum Siebold & Zucc (68 mg/ tablet), Citrus reticulata Blanco (27.2 mg/tablet), Curcuma kwangsiensis S.G.Lee & C.F.Liang (40.8 mg/tablet), Crataegus pinnatifida Bunge (68 mg/tablet) and Imperata cylindrica (L.) P. Beauv. (40.8 mg/tablet) etc.…”

Section: Introductionmentioning

confidence: 99%

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Danning tablets might improve glucose and lipid metabolism in asymptomatic T2MD patients after cholecystectomy

Chen

Zhou²,

Xiao³

et al. 2021

Medicine

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Considering the role of bile acids in glucose metabolism and the effect of farnesoid X receptor agonists on bile acids, we investigated the possible effect of Danning tablets (DNTs), a type of farnesoid X receptor agonist, on glucose and lipid metabolism in asymptomatic type 2 diabetes mellitus (T2DM) patients. A series of asymptomatic T2DM patients who underwent cholecystectomy at least 2 years prior and were regularly followed up in our hospital were included in our analysis. According to their choice, they were divided into 2 groups: the DNT group and the control group. Demographic data, body weight, food intake, effects on diabetes control, and biomedical variables were collected. After propensity score matching, a total of 64 T2DM patients (41 males and 23 females) were included in the analysis. The amount of daily food intake (kcals) and diet composition were little changed 6-months after DNT administration ( P = .612). However, the average fasting glucose level of the DNT group decreased from 9.5 ± 1.4 mmol/L to 8.3 ± 1.6 mmol/L ( P < .001), and the level of hemoglobin A1c decreased from 8.3 ± 1.1% to 7.6 ± 1.0% ( P = .001). The total cholesterol level ( P = .024) and low-density lipoprotein cholesterol level ( P = .034) decreased significantly ( P = .018). Moreover, the average level of total bile acids decreased from 6.05 ± 2.60 μmol/L to 5.10 ± 1.83 μmol/L in the DNT group ( P = .037), and the level of glucagon-like peptide-1 significantly increased from 6.93 ± 4.94 pmol/L to 11.25 ± 5.88 pmol/L ( P < .001). The results of our study show that DNT intake improved glucose and lipid metabolism and increased the level of glucagon-like peptide-1. Trial registration: registered in Chinese Clinical Trial Registry (No. ChiCTR1900027823).

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Biliary Jejunostomy Might Improve Glucose in Type 2 Diabetes Patients

Cited by 2 publications

References 24 publications

Biliary diversion increases resting energy expenditure leading to decreased blood glucose level in mice with type 2 diabetes

Biliary diversion increases resting energy expenditure leading to decreased blood glucose level in mice with type 2 diabetes

Danning tablets might improve glucose and lipid metabolism in asymptomatic T2MD patients after cholecystectomy

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