{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:42:30Z","timestamp":1788266550760,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The reproductive disorders of BPD\/DS group were almost completely restored 8 weeks after surgery, and the AUC\n                      <jats:sub>OGTT<\/jats:sub>\n                      value and the AUC\n                      <jats:sub>ITT<\/jats:sub>\n                      value were statistically less than those of the S-BPD group (\n                      <jats:italic>P<\/jats:italic>\n                      =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 (\n                      <jats:italic>P &amp;lt;<\/jats:italic>\n                      0.05). Moreover, high level of bile acids and low level of ceramides were observed in the BPD\/DS group (\n                      <jats:italic>P &amp;lt;<\/jats:italic>\n                      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\n                      <jats:sub>OGTT<\/jats:sub>\n                      value increased from 818.3 \u00b1 297.3 mmol\/L\u00b7min to 1147.9 \u00b1 167.9 mmol\/L\u00b7min (\n                      <jats:italic>P<\/jats:italic>\n                      =0.007) and the AUC\n                      <jats:sub>ITT<\/jats:sub>\n                      value increased from 525.6 \u00b1 52.3 mmol\/L\u00b7min to 577.7 \u00b1 102.9 mmol\/L\u00b7min (\n                      <jats:italic>P<\/jats:italic>\n                      =0.023).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1720242","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T05:22:35Z","timestamp":1770268955000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Biliopancreatic diversion with duodenal switch improve polycystic ovary syndrome with decreased serum ceramides"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaochuan","family":"Li","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Women's Health and Obstetric and Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College","place":["Beijing, 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