TOPLINE:

Individuals with a history of cholecystectomy have higher sleep energy expenditure, lower respiratory exchange ratios (RERs), and greater lipid oxidation than those without, suggesting that gallbladder removal may influence metabolic fuel selection and basal metabolic rate, according to a cross-sectional study of Indigenous American adults.

METHODOLOGY:

• Cholecystectomy alters bile flow and exposure to bile acids, which may have potential consequences for energy metabolism that are not fully understood.
• Researchers conducted a cross-sectional study of Indigenous American adults, comparing participants with and without cholecystectomy to assess differences in energy expenditure, RER, and substrate oxidation.
• Participants completed 24-hour energy metabolism measurements in a whole-room respiratory chamber after consuming a weight-maintaining diet (50% carbohydrate, 30% fat, and 20% protein) for at least 5 days; body composition was also assessed.
• Twenty-four-hour energy expenditure, RER, and rates of substrate (lipid, carbohydrate, and protein) oxidation were quantified using indirect calorimetry.
• Fasting blood samples were analyzed to measure bile acid concentrations and evaluate potential associations with energy metabolism outcomes.

TAKEAWAY:

• Among 384 participants (mean age, 27.7 years; 42% female), 39 had a history of cholecystectomy and 345 did not.
• Individuals with a history of cholecystectomy had significantly higher sleep energy expenditure than those without (P = .006).
• In covariate-adjusted models, the cholecystectomy group had a significantly lower total RER (P = .01) and nonprotein RER (P = .01) and higher lipid oxidation rates (P = .03) than the non-cholecystectomy group.
• Levels of certain bile acids — including glycocholic acid, glycochenodeoxycholic acid, and glycoursodeoxycholic acid — were higher in the cholecystectomy group; however, these levels were not associated with differences in energy expenditure.

IN PRACTICE:

“[Cholecystectomy] may have lasting effects on energy metabolism and substrate utilization, highlighting the need to consider metabolic outcomes when deciding on surgery and managing patients post-surgery,” the authors of the study wrote.

SOURCE:

The study was led by Beyza N. Aydin, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix. It was published online in Obesity.

LIMITATIONS:

Only Indigenous American participants were included, limiting generalizability to other populations. The cross-sectional design prevented the assessment of temporal changes in energy metabolism. Habitual food intake before the inpatient stay may have influenced RER measurements.

DISCLOSURES:

The study was supported by the Intramural Research Program of the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.