ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Microorganisms in Vertebrate Digestive Systems
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1579149
SADI-S and SG surgeries induce distinct bile acid profiles linked to improved glucose metabolism via microbiota interactions
Provisionally accepted
- 1Jilin University, Changchun, China
- 2Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
- 3First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Introduction: Although bariatric surgery profoundly ameliorates type 2 diabetes (T2D), the mechanisms whereby specific procedures confer metabolic benefits through bile acid (BA) remodeling remain incompletely defined. This study compared the effects of single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) and sleeve gastrectomy (SG) on BA profiles and their association with metabolic outcomes in a rodent model of T2D. Methods: Male Wistar rats with T2D underwent SADI-S, SG, or sham operation. Metabolic parameters, including fasting blood glucose, HbA1c, glucagon-like peptide-1 levels, triglycerides, gut microbiota composition, and comprehensive serum/faecal BA profiles, were assessed five weeks post-surgery. Statistical analyses included t-tests and Pearson correlations, with false discovery rate correction applied. Results: Both SADI-S and SG significantly ameliorated hyperglycemia, dyslipidemia, and β-cell integrity compared to sham operation, with SADI-S demonstrating superior efficacy. SADI-S induced a more pronounced elevation of portal serum BAs (34 vs. 25 species in SG), including key regulators such as chenodeoxycholic acid and lithocholic acid. Critically, multiple elevated serum BAs (e.g., chenodeoxycholic acid, lithocholic acid, glycoursodeoxycholic acid) exhibited strong negative correlations with fasting blood glucose, HbA1c, and triglycerides, while positively correlating with glucagon-like peptide-1 levels. Shifts in gut microbiota correlated with specific BA changes, supporting a 'microbiota-BA-metabolism' axis. Conclusions: SADI-S and SG induce distinct, surgery-specific BA remodeling that is significantly associated with metabolic improvements in T2D. The robust correlations between specific BA species and metabolic parameters underscore their potential as mediators and therapeutic targets. SADI-S promotes a more extensive and beneficial BA profile, aligning with its superior metabolic efficacy.
Keywords: Single-anastomosis duodenal-ileal bypass with sleeve gastrectomy, sleeve gastrectomy, Bile acid, Gut Microbiota, T2D
Received: 19 Feb 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Ma, Zheng, Wei, Hu, Wang, Shen, Fang and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tao Jiang, Jilin University, Changchun, China
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