THU142 One-year Change In Bile Acids And Its Association With Changes In Metabolic Profile After Sleeve Gastrectomy In Youth

Disclosure: S. Tuli: None. S. Kaur: None. M. Bredella: None. M. Misra: None. V. Singhal: None. Introduction: Bile acids (BAs) are hydroxylated steroid acids. Primary (10) BAs (cholic acid (CA) and chenodeoxycholic acid (CDCA) are synthesized by the liver. Secondary (20) BAs (deoxycholic acid (DCA) and ursodeoxycholic acid (UDCA) are formed from 10 BAs by the action of intestinal flora. Preclinical studies indicate a role of BAs in weight loss and metabolic improvements after metabolic and bariatric surgery (MBS). Data are inconsistent regarding changes in BAs after sleeve gastrectomy (SG), the most common MBS. Further, how BA changes contribute to metabolic improvements after SG is unclear. Objective: Evaluate changes in serum BAs 1 year after SG in youth with obesity and associations with changes in metabolic parameters. Methods: 16 adolescents (75% females) 13-22 years old with severe obesity were followed for one-year post-SG with assessments at baseline and during a mixed meal tolerance test (MMTT). We measured fasting BAs, glucose, insulin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lipids. Blood was drawn at 15, 30, 60, 90, and 120 minutes for glucose and insulin and at 0, 15, 60, and 120 minutes for BAs. Data are reported as changes over 15 minutes [t15–t0 of MMTT (Δ15)], area under the curve (AUC), and % change. Results: BMI decreased by 25.7% (p<0.0001). For 10 BAs: fasting CA levels decreased (33.3%, p=0.005), while Δ15 CA, CDCA and, total 10 BAs (113.3%, 188.9%, 152.9%, p<0.005), and AUC for CDCA and total 10 BAs (34.2%, p=0.004; 30.3%, p=0.015) increased one-year post-SG. For 20 BA: Δ15 DCA and total 20 BAs (212.5%, p≤0.011; 195.2%, p=0.004), and AUC DCA and total 20 BAs (95.0%, p=0.031; 59.4%, p=0.035) increased. Δ15 and AUC total BA also increased (100%, p=0.002; 1060.9%, p≤0.0001). Insulin resistance (HOMA-IR) (58.6%), low-density lipoprotein (LDL) (11.2%), triglyceride (14.6%), and ALT (26.9%) decreased (p<0.05), while high-density lipoprotein (HDL) levels (10.2%, p=0.04) increased. Decreases in AUC insulin were associated with increases in AUC 20/10 BA (ρ=-0.687, p=0.009). HBA1C decreases were associated with increases in AUC total BAs (ρ=-0.531, p=0.034). Increases in the insulinogenic index (Δ30 Insulin/ Δ30 glucose) correlated positively with fasting DCA (ρ=0.567, p=0.028). Increases in HDL were associated with increases in fasting CA (ρ=0.580, p=0.018) and UDCA (ρ=0.592, p=0.016). Conclusion: Total, 10, and 20 bile acids increase after SG in youth associated with improvements in metabolic profile. Presentation: Thursday, June 15, 2023