title: Sleeve gastrectomy, but not duodenojejunostomy, preserves total beta-cell mass in Goto-Kakizaki rats evaluated by three-dimensional optical projection tomography.
abstract: BACKGROUND
  In type 2 diabetes mellitus, there is a progressive loss of beta-cell mass. Bariatric surgery has in recent investigations showed promising results in terms of diabetes remission, but little is established regarding the effect of surgery on the survival or regeneration of pancreatic beta-cells. In this study, we aim to explore how bariatric surgery with its subsequent hormonal alterations affects the islets of Langerhans.
  
  
  METHODS
  Twenty-four Goto-Kakizaki rats were operated with duodenojejunostomy (DJ), sleeve gastrectomy (SG) or sham operation. From the 38th week after surgery, body weight, fasting blood glucose, glycosylated hemoglobin, mixed meal tolerance with repeated measures of insulin, glucagon-like peptide 1, gastrin and total ghrelin were evaluated. Forty-six weeks after surgery, the animals were euthanized and the total beta-cell mass in all animals was examined by three-dimensional volume quantification by optical projection tomography based on the signal from insulin-specific antibody staining.
  
  
  RESULTS
  Body weight did not differ between groups (P(g) = 0.37). SG showed lower fasting blood glucose compared to DJ and sham (P(g) = 0.037); HbA1c levels in SG were lower compared to DJ only (p < 0.05). GLP-1 levels were elevated for DJ compared to SG and sham (P(g) = 0.001), whereas gastrin levels were higher in SG compared to the two other groups (P(g) = 0.002). Beta-cell mass was significantly greater in animals operated with SG compared to both DJ and sham (p = 0.036).
  
  
  CONCLUSIONS
  Sleeve gastrectomy is superior to duodenojejunostomy and sham operation when comparing the preservation of beta-cell mass 46 weeks after surgery in Goto-Kakizaki rats. This could be related to both the increased gastrin levels and the long-term improvement in glycemic parameters observed after this procedure.
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, 7491, Trondheim, Norway. eivig@stud.ntnu.no.
authors.forename: Eivind
authors.initials: E
authors.lastname: Grong
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, 7491, Trondheim, Norway.|Centre of Obesity, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Bård
authors.initials: B
authors.lastname: Kulseng
authors.affiliation: Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Ingerid Brænne
authors.initials: IB
authors.lastname: Arbo
authors.affiliation: Umeå Center for Molecular Medicine (UCMM), Umeå University, Umeå, Sweden.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Nord
authors.affiliation: Umeå Center for Molecular Medicine (UCMM), Umeå University, Umeå, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Eriksson
authors.affiliation: Umeå Center for Molecular Medicine (UCMM), Umeå University, Umeå, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Ahlgren
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, 7491, Trondheim, Norway.|Centre of Obesity, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.|Department of Gastrointestinal Surgery and Norwegian National Advisory Unit on Advanced Laparoscopic Surgery (NSALK), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Ronald
authors.initials: R
authors.lastname: Mårvik
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D050110:Bariatric Surgery / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D021621:Imaging, Three-Dimensional; D050417:Insulin-Secreting Cells / Q000473:pathology*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D009929:Organ Size; D051381:Rats; D011919:Rats, Inbred Strains; D041622:Tomography, Optical / Q000379:methods; D016896:Treatment Outcome
keywords: Beta-cell mass; Duodenojejunostomy; Gastrin; Glucagon-like peptide 1; Goto-Kakizaki rats; Optical projection tomography; Sleeve gastrectomy; Type 2 diabetes mellitus