title: Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model.
abstract: BACKGROUND
  Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).
  
  
  METHODS
  Forty 10-week-old male Zucker diabetic fatty rats were randomly assigned to four groups: control, SG, JI-SG, and RYGB. Their body weights, food intake, and levels of gut hormones (ghrelin, insulin, and glucagon-like peptide-1 (GLP-1)) and lipids were measured.
  
  
  RESULTS
  Rats in the SG, JI-SG, and RYGB groups demonstrated lower food intake and more weight loss 2 weeks postoperatively compared with control rats. Furthermore, rats in the JI-SG group achieved more weight loss (mean 242.7 ± 11.2 g) compared with those in the SG and RYGB groups (SG, 401.4 ± 15.1 g and RYGB, 298 ± 12 g, both P < 0.01). All surgery groups demonstrated a decreased fasting insulin, serum glucose, lipid levels, and increased GLP-1 postoperatively. The JI-SG group had lower fasting ghrelin levels than the RYGB group (168 ± 19.8 ng/L vs. 182 ± 16.7 ng/L, P < 0.01) and higher fasting GLP-1 levels than the SG group (1.99 ± 0.11 pmol/L vs. 1.71 ± 0.12 pmol/L, P < 0.01) at 12 weeks postoperatively. Over the experimental period, the ghrelin levels slowly increased in all surgical groups but remained lower than the preoperative and control levels.
  
  
  CONCLUSIONS
  JI-SG induced higher ghrelin and GLP-1 levels and improved glycemic control in Zucker diabetic fatty rats. Compared with SG and RYGB, JI-SG appeared to be a simple, relatively safe, and more effective procedure for treating type 2 diabetes and obesity in this animal model.
authors.affiliation: Department of General Surgery, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092, China.
authors.forename: Kaijing
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Oakwood Southshore Medical Center, Trenton, MI, USA.
authors.forename: Giang
authors.initials: G
authors.lastname: Quach
authors.affiliation: Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
authors.forename: Jiajun
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
authors.forename: Anan
authors.initials: A
authors.lastname: Xu
authors.affiliation: Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China. zhujiangfan@hotmail.com.
authors.forename: Jiangfan
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000601:surgery*; D004195:Disease Models, Animal; D004435:Eating; D005215:Fasting; D005743:Gastrectomy / Q000379:methods*; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D007082:Ileum / Q000601:surgery*; D007328:Insulin / Q000097:blood; D007583:Jejunum / Q000601:surgery*; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000601:surgery; D011897:Random Allocation; D051381:Rats; D011924:Rats, Zucker
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D052216:Glucagon-Like Peptide 1
keywords: Jejunoileal anastomosis; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type 2 diabetes; Zucker diabetic fatty rat