title: Malabsorption plays a major role in the effects of the biliopancreatic diversion with duodenal switch on energy metabolism in rats.
abstract: BACKGROUND
  The mechanisms underlying the metabolic benefits of the biliopancreatic diversion with duodenal switch (BPD/DS) have not been clarified. The objective of this study was to investigate the metabolic roles of sleeve gastrectomy (SG) and duodenal switch (DS) as main surgical components of BPD/DS.
  
  
  METHODS
  BPD/DS, SG, and DS surgeries were performed on chow-fed nonobese Wistar rats. Weight and energy intake were recorded during 8 postsurgical weeks. Glucagon-like peptide 1 (GLP-1), peptide tyrosine-tyrosine (PYY), glucose-dependent insulinotropic peptide, and ghrelin were measured pre- and postprandially at weeks 3 and 8, after surgery. Body composition, muscle, liver, and adipose tissue weights were measured. Gut morphometry and the presence and distribution of GLP-1 and PYY (L-cells) in the gut were determined using histochemical techniques.
  
  
  RESULTS
  Compared with sham, BPD/DS and DS led to significant reductions in weight gain, percentage of fat, and adipose tissue weight. These effects were accompanied by a reduction in digestible energy intake associated with fecal energy loss due to DS. BPD/DS and DS produced intestinal hypertrophy, as well as higher plasma GLP-1 and PYY in both fasted and refed states. It is noteworthy that none of those alterations were observed after SG, which nonetheless led to transient postoperative reduction in gross energy intake and weight. Similar to BPD/DS, SG alone produced a reduced meal size and an enhanced postprandial depression of plasma ghrelin.
  
  
  CONCLUSIONS
  BPD/DS results in metabolic benefits, which appear largely caused by food malabsorption due to DS. The elevation of anorectic GLP-1 and PYY are additional consequences of DS, which, together with malabsorption, could promote the metabolic benefits of BPD/DS.
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada.
authors.forename: Elena-Dana
authors.initials: ED
authors.lastname: Baraboi
authors.affiliation: Department of Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
authors.forename: Nina L
authors.initials: NL
authors.lastname: Cluny
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Roy
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Samson
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada.
authors.forename: Laurent
authors.initials: L
authors.lastname: Biertho
authors.affiliation: Department of Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Sharkey
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada. Electronic address: denis.richard@criucpq.ulaval.ca.
authors.forename: Denis
authors.initials: D
authors.lastname: Richard
mesh_terms: D000818:Animals; D015904:Biliopancreatic Diversion; D001823:Body Composition; D004386:Duodenum / Q000601:surgery*; D002149:Energy Intake; D004734:Energy Metabolism / Q000502:physiology*; D005743:Gastrectomy; D005768:Gastrointestinal Hormones / Q000378:metabolism; D007408:Intestinal Absorption / Q000502:physiology*; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D015431:Weight Loss
chemical_list: D005768:Gastrointestinal Hormones
keywords: Bariatric surgery; Body composition; Energy intake; Gastrointestinal hormones; Malabsorption