The role of fibroblast growth factor 19 in pathogenesis of bile acid diarrhea of the patients who underwent cholecystectomy

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Abstract

The occurrence of chronic diarrhea after cholecystectomy (CCY) has been described by many researchers. However, the main mechanisms of the development of this diarrhea are not fully understood. Supposed that dysregulation of the bile acids (ВA) absorption in the ileum is played a significant role in the development of diarrhea syndrome.

Aim. To determine the role of the fibroblast growth factor 19 (FGF19) level in the serum and BA concentration in feces in pathogenesis of bile acid diarrhea (ВАD) in patients after CCY.

Materials and methods. Sixty-one patients were examined at various times after CCY: 30 patients with chronic diarrhea that appeared after CCY (group 1) and 31 patients with normal stools (group 2). In all patients, the level of FGF19 in the blood serum, and the daily excretion of BA in the feces were studied. The control group consisted of 28 healthy individuals.

Results. In the 1st group we found lower concentrations of FGF19 in the blood serum 86.2 ng/ml (67.8; 117.8) compared with concentrations in the 2nd group – 259 ng/ml (170.6; 318.8), p<0.001. The daily excretion of bile acids with feces in the 1st group was 657.4 mg/day (524.6; 830.1), which was twice more than in the 2nd group and the control group. It was established an inverse correlation between serum concentration of the FGF19 and the BA excretion in the feces in all examined patients. It indicates a possible relationship between the low concentration of FGF19 in blood serum and malabsorption of the BA.

Conclusion. Low level of FGF19 in the blood serum and a high excretion of BA in the feces may be one of the causes of BAD in patients undergoing cholecystectomy. Our results indicate the important role of FGF19 in the development of chronic diarrhea, which can be considered as one of the variants of postcholecystectomy syndrome.

About the authors

L. Кh. Indeykina

Loginov Moscow Clinical Scientific Center; Research Institute for Healthcare Organization and Medical Management

Email: asfold@mail.ru
ORCID iD: 0000-0002-3829-3211

зав. лаб. функциональной диагностики заболеваний кишечника ГБУЗ «МКНЦ им. А.С. Логинова», вед. специалист ОМО по гастроэнтерологии ГБУ НИИОЗММ

Russian Federation, Moscow; Moscow

Е. А. Sabelnikova

Loginov Moscow Clinical Scientific Center

Email: asfold@mail.ru
ORCID iD: 0000-0001-7519-2041

д.м.н., зам. дир. по научной работе ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

G. G. Varvanina

Loginov Moscow Clinical Scientific Center

Email: asfold@mail.ru
ORCID iD: 0000-0002-2305-0671

д.м.н., ст. науч. сотр. лаб. научно-диагностических исследований ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

S. U. Silvestrova

Loginov Moscow Clinical Scientific Center

Email: asfold@mail.ru
ORCID iD: 0000-0003-0479-9422

к.б.н., ст. науч. сотр. лаб. лекарственного метаболизма ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

А. V. Smirnova

Loginov Moscow Clinical Scientific Center; 3Blokhin National Medical Research Center of Oncology

Email: asfold@mail.ru
ORCID iD: 0000-0003-0386-9732

науч. сотр. лаб. доклинических исследований ГБУЗ «МКНЦ им. А.С. Логинова», ст. науч. сотр. лаб. радионуклидных и лучевых технологий в экспериментальной онкологии ФГБУ «НМИЦ онкологии им. Н.Н. Блохина»

Russian Federation, Moscow; Moscow

L. М. Krums

Loginov Moscow Clinical Scientific Center

Email: asfold@mail.ru
ORCID iD: 0000-0003-0692-7133

д.м.н., ст. науч. сотр. отд-ния невоспалительной патологии кишечника ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

A. A. Viaznikova

Loginov Moscow Clinical Scientific Center

Email: asfold@mail.ru
ORCID iD: 0000-0003-1050-2437

мл. науч. сотр. лаб. функциональной диагностики заболеваний кишечника ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

А. I. Parfenov

Loginov Moscow Clinical Scientific Center

Author for correspondence.
Email: asfold@mail.ru
ORCID iD: 0000-0002-9782-4860

д.м.н., проф., зав. отд. патологии кишечника ГБУЗ «МКНЦ им. А.С. Логинова»

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Рис. 1. Суточная экскреция ЖК в кале в норме и у обследованных больных.

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3. Рис. 2. Концентрация FGF19 в сыворотке крови в норме и у обследованных больных.

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4. Рис. 3. Корреляционная зависимость между концентрацией FGF19 в сыворотке крови и суточной концентрацией ЖК в кале.

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