A systematic review and meta‐analysis was conducted of studies that address the association of bile acid (BA) with obesity and of studies on the effects of treatment in patients with obesity on BA metabolism, assessed from systemic BA, fibroblast growth factor 19 (FGF19), 7α‐hydroxy‐4‐cholesten‐3‐one (C4) level, and faecal BA. We searched PubMed, Embase, and the Cochrane Library from inception to 1 August 2019 using the keywords obesity, obese, body mass index, and overweight with bile acid, FGF19, FXR, and TGR5. Two reviewers independently searched, selected, and assessed the quality of studies. Data were analysed using either fixed or random effect models with inverse variance weighting. Of 3771 articles, 33 papers were relevant for the association of BA with obesity of which 22 were included in the meta‐analysis, and 50 papers were relevant for the effect of obesity interventions on BA of which 20 were included in the meta‐analysis. Circulating fasting total BA was not associated with obesity. FGF19 was inversely and faecal BA excretion was positively associated with obesity. Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy (SG) modulated BA metabolism, ie, increased BA and FGF19. Our results indicate that BA metabolism is altered in obesity. Certain bariatric surgeries including RYGB and SG modulate BA, whether these underlie the beneficial effect of the treatment should be investigated.

中文翻译：

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针对减少肥胖症的胆汁酸代谢：系统评价和荟萃分析。

通过系统性BA，​​成纤维细胞生长因子19（FGF19）评估，对涉及胆汁酸（BA）与肥胖症之间关系的研究以及肥胖症患者的治疗对BA代谢的影响进行了系统的综述和荟萃分析。 ），7α-羟基-4-胆固醇3（C4）水平和粪便BA。检索PubMed，Embase和Cochrane图书馆从成立到2019年8月1日使用关键字肥胖，肥胖，体重指数，以及超重与胆汁酸，FGF19，FXR和TGR5。两名审稿人独立搜索，选择和评估研究质量。使用具有反方差加权的固定或随机效应模型分析数据。在3771篇文章中，有33篇关于BA与肥胖相关的论文，其中有22篇纳入荟萃分析，有50篇关于肥胖干预对BA的影响相关，其中20篇纳入荟萃分析。空腹循环总BA与肥胖无关。FGF19相反，而粪便BA排泄与肥胖呈正相关。Roux-en-Y胃旁路（RYGB）和袖胃切除术（SG）调节BA代谢，即增加BA和FGF19。我们的结果表明，肥胖者的BA代谢发生改变。某些减肥手术（包括RYGB和SG）会调节BA，