Original article Long-term effects of Roux-en-Y gastric bypass on postprandial plasma lipid and bile acids kinetics in female non diabetic subjects: A cross-sectional pilot study Sara De Giorgi a , Vanessa Campos a , Leonie Egli a , Ulrike Toepel b , Guillaume Carrel a , Bertrand Cariou c , Dominique Rainteau d , Philippe Schneiter a , Luc Tappy a, * , Vittorio Giusti e a Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland b Departments of Radiology and Clinical Neurosciences, University Hospital and University of Lausanne, Switzerland c INSERM, UMR1087-CNRS UMR6291, l'Institut du Thorax, Facult e de M edecine, Universit e de Nantes, F-44000 Nantes, France d Sorbonne Universit es e UPMC Univ Paris 06, INSERM ERL 1157, CNRS UMR 7203 LBM, CHU Saint-Antoine, Paris, France e Center for Metabolic Diseases, Department of Internal Medicine, Broye Intercantonal Hospital, Estavayer-le-lac, Switzerland article info Article history: Received 15 July 2014 Accepted 22 September 2014 Keywords: Triglyceride-rich lipoproteins Apoprotein B48 Gut hormones Bile acids Fibroblast growth factor 19 Bariatric surgery summary Background and aims: Formerly obese patients having undergone Roux-en-Y gastric bypass (RYGB) display both an accelerated digestion and absorption of carbohydrate and an increased plasma glucose clearance rate after meal ingestion. How RYGB effects postprandial kinetics of dietary lipids has yet not been investigated. Methods: Plasma triglyceride (TG), apoB48, total apoB, bile acids (BA), fibroblast growth factor 19 (FGF19), and cholecystokinin (CCK) were measured in post-absorptive conditions and over 4-h following the ingestion of a mixed test meal in a cross-sectional, pilot study involving 11 formerly obese female patients 33.8 ± 16.4 months after RYGB surgery and in 11 weight- and age-matched female control participants. Results: Compared to controls, RYGB patients had faster (254 ± 14 vs. 327 ± 7 min, p < 0.05) and lower (0.14 ± 0.04 vs. 0.35 ± 0.07 mM, p < 0.05) peak TG responses, but their peak apoB48 responses tended to be higher (2692 ± 336 vs. 1841 ± 228 ng/ml, p ¼ 0.09). Their postprandial total BA concentrations were significantly increased and peaked earlier after meal ingestion than in controls. Their FGF19 and CCK concentrations also peaked earlier and to a higher value. Conclusions: The early postprandial apoB48 and BA responses indicate that RYGB accelerated the rate of dietary lipid absorption. The lower postprandial peak TG strongly suggests that the RYGB simultaneously increased the clearance of TG-rich lipoproteins. Clinical trial registration: NCT01891591. © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. 1. Introduction Roux-en-Y Gastric Bypass (RYGB) is a widely used procedure for the surgical treatment of severe obesity. In Switzerland, where obesity prevalence rate is about 9% (http://www.oecd.org/health/ obesity-update.htm, released 27 May 2014), it was recently esti- mated that about 2566 bariatric surgery procedures (0.03% of the Swiss population) were performed yearly, of which 1991 RYGB procedures [1].RYGP results in a rapid improvement of blood glucose control and insulin resistance in obese patients with type 2 diabetes mellitus. This may be due to the rapid delivery of ingested carbohydrates to distal portions of the small intestine and the co- lon, which is associated with an enhanced secretion of GLP-1, a potentiation of insulin secretion, and an increase in glucose meta- bolic clearance [2,3]. Beside improving glucose homeostasis, RYGB is also associated with an improved plasma lipid profile in Abbreviations: RYGB, Roux-en-Y-gastric bypass; TG, triglycerides; ApoB, apoli- poprotein B; VLDL, very low density lipoprotein; C4, 7-alpha hydroxy 4-cholesten-3 one; BA, bile acids. * Corresponding author. Department of Physiology, University of Lausanne, rue du Bugnon 7, CH-1005 Lausanne, Switzerland. Tel.: þ41 21 692 55 41; fax: þ41 21 692 55 95. E-mail address: luc.tappy@unil.ch (L. Tappy). Contents lists available at ScienceDirect Clinical Nutrition journal homepage: http://www.elsevier.com/locate/clnu http://dx.doi.org/10.1016/j.clnu.2014.09.018 0261-5614/© 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. Clinical Nutrition 34 (2015) 911e917