Biliopancreatic diversion with duodenal switch improve polycystic ovary syndrome with decreased serum ceramides

Background Polycystic ovary syndrome (PCOS) is characterized primarily by insulin resistance and reproductive disorders. Biliopancreatic diversion with duodenal switch (BPD/DS) could significantly improve insulin sensitivity with significantly elevated level of bile acids. We aimed to explore changes in PCOS manifestations after BPD/DS and the possible mechanisms. Methods Twenty PCOS rat models were assigned into the BPD/DS group and the sham BD (S-BPD) group randomly. The fasting blood glucose, bile acids, and ceramides levels in serum samples were assessed. Results The reproductive disorders of BPD/DS group were almost completely restored 8 weeks after surgery, and the AUC OGTT value and the AUC ITT value were statistically less than those of the S-BPD group ( P =0.001). The concentration of serum testosterone, luteinizing hormone, and follicle-stimulating hormone of the BPD/DS group was statistically less than that of the S-BPD group ( P < 0.05). Moreover, high level of bile acids and low level of ceramides were observed in the BPD/DS group ( P < 0.001). Bile acid sequestrant was given to the BPD/DS group rats for 1 week, the level of bile acids decreased and ceramides increased, the insulin resistance worsened. The AUC OGTT value increased from 818.3 ± 297.3 mmol/L·min to 1147.9 ± 167.9 mmol/L·min ( P =0.007) and the AUC ITT value increased from 525.6 ± 52.3 mmol/L·min to 577.7 ± 102.9 mmol/L·min ( P =0.023). Conclusions Our study showed the improvement of insulin resistance in PCOS models after BPD/DS with decreased serum ceramides. The sequestrant of bile acid reversed the improvement of insulin resistance with higher ceramides level.