title: Systematic ileal transposition in Zucker rats shows advantage for long segment distal transposition.
abstract: BACKGROUND
  The possibility of achieving diabetes remission through bariatric surgery has dramatically changed treatment options for this disease. Ileal transposition (IT), specifically designed to provoke diabetes remission, has so far shown great success in rodent studies. However, it remains uncertain which combination of ileal length and origin produces best results.
  
  
  METHODS
  Forty male Zucker rats underwent transposition of 25% distal, 50% distal, and 50% proximal ileum or sham surgery. Glucose control, insulin, and glucagon-like peptide (GLP)-1 serum levels were analyzed after 1, 3, and 6 months. Body weight was recorded weekly.
  
  
  RESULTS
  In relation to sham-operated animals, the 50% distal IT presented with improved glucose tolerance after 1, 3, and 6 months (2-way analysis of variance [ANOVA]: P < .05, < .0001, and < .0001, respectively). The 25% distal and 50% proximal IT only showed improved glucose control after 3 months, suggesting a fading effect in long-term observation (2-way ANOVA: P < .0001 for both). Glucose-stimulated GLP-1 levels were steadily elevated only in the 2 distal IT groups (Mann-Whitney sham versus 50% distal, P < .01, < .01, and < .05; sham versus 25% distal, P < .01, = .001, < .05 for 1, 3, and 6 months, respectively). IT had no impact on serum insulin levels.
  
  
  CONCLUSIONS
  The current study restates the findings of improved glucose tolerance and GLP-1 stimulation after IT, but is the first to demonstrate a fading glycemic effect in long-term observation. Systematic comparison of length and ileal origin revealed that long and distal transposition delivers best results.
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Freiburg, Germany. Electronic address: jodok.grueneberger@uniklinik-freiburg.de.
authors.forename: Jodok Matthias
authors.initials: JM
authors.lastname: Grueneberger
authors.affiliation: Department of Physiology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Karcz-Socha
authors.affiliation: Department of Physiology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Tomek
authors.initials: T
authors.lastname: Sawczyn
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Freiburg, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Kosmowski
authors.affiliation: Department of Physiology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Dominica
authors.initials: D
authors.lastname: Stygar
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Freiburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Goos
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Freiburg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Küsters
authors.affiliation: Department of Physiology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Zwirska-Korczala
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Freiburg, Germany.
authors.forename: Goran
authors.initials: G
authors.lastname: Marjanovic
authors.affiliation: Department of Surgery, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Keck
authors.affiliation: Department of General and Visceral Surgery, Albert-Ludwigs-University, Freiburg, Germany.
authors.forename: Ulrich Theodor
authors.initials: UT
authors.lastname: Hopt
authors.affiliation: Department of Surgery, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany.
authors.forename: W Konrad
authors.initials: WK
authors.lastname: Karcz
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods*; D001835:Body Weight; D003921:Diabetes Mellitus, Experimental / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D005951:Glucose Tolerance Test; D007082:Ileum / Q000601:surgery*; D008297:Male; D009765:Obesity / Q000150:complications / Q000601:surgery; D051381:Rats; D011924:Rats, Zucker
chemical_list: D052216:Glucagon-Like Peptide 1