title: Side-to-Side Jejunoileal Bypass Induces Better Glucose-Lowering Effect than End-to-Side Jejunoileal Bypass on Nonobese Diabetic Rats.
abstract: BACKGROUND
  Jejunoileal bypass (JIB) can markedly ameliorate diabetes in obese patients and rodents. The aim of this study is to systematically evaluate the role of the operational manner and the retained distal small bowel length in mediating changes in glucose homeostasis after intestinal bypass surgeries in nonobese diabetic rats.
  
  
  METHODS
  Streptozotocin-induced diabetic rats underwent side-to-side jejunoileal bypass plus proximal loop ligation (SSJIBL), end-to-side jejunoileal bypass (ESJIB), proximal small bowel resection (PBR), and sham operation. Each operational manner included two subgroups, in which 30 cm (L-30) or 40 cm (L-40) distal small bowel was retained. Main outcome measures were fasting blood glucose levels (FBG), insulin sensitivity, serum insulin, glucagon-like peptide-1 (GLP-1), bilirubin (BIL), and total bile acids (TBA) levels.
  
  
  RESULTS
  Global food intake in the sham group was higher than in the operation groups, and global body weight and food intake in the SSJIBL group were higher than in the ESJIB and PBR groups. Global body weight and food intake in L-40 group were higher than in L-30 group. The SSJIBL procedure induced better improvement in glucose homeostasis and insulin sensitivity than the ESJIB and PBR procedures, and L-30 group showed better antidiabetic effects than L-40 group. Serum GLP-1, BIL, and TBA levels in SSJIBL group were higher than in ESJIB and PBR groups.
  
  
  CONCLUSIONS
  This study shows that side-to-side jejunoileal bypass induced better glucose-lowering effects than end-to-side jejunoileal bypass and proximal small bowel resection, and intestinal bypass surgery that retained shorter distal small bowel yielded better antidiabetic effects.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital of Soochow University, No.188 Shizi Road, Suzhou, Jiangsu Province, 215006, People's Republic of China, jinyuan201314@outlook.com.
authors.forename: Jinyuan
authors.initials: J
authors.lastname: Duan
authors.forename: Cai
authors.initials: C
authors.lastname: Tan
authors.forename: Hang
authors.initials: H
authors.lastname: Xu
authors.forename: Shaolin
authors.initials: S
authors.lastname: Nie
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism*; D003921:Diabetes Mellitus, Experimental / Q000097:blood* / Q000139:chemically induced / Q000150:complications / Q000601:surgery*; D015536:Down-Regulation; D004435:Eating / Q000502:physiology; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D007421:Intestine, Small / Q000601:surgery; D007581:Jejunoileal Bypass / Q000379:methods*; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery; D051381:Rats; D017207:Rats, Sprague-Dawley; D013311:Streptozocin
chemical_list: D001786:Blood Glucose; D013311:Streptozocin; D052216:Glucagon-Like Peptide 1