title: The role of foregut exclusion in the deterioration of glucose and lipid metabolism induced by a high-fat diet.
abstract: OBJECTIVE
  The small intestine may be involved in the improvement of glucose and lipid metabolism after bariatric surgery; however, the role of the foregut in metabolic changes remains unclear. This study used normal rats fed a high-fat diet (HFD) after bariatric surgery to determine the role of the foregut in glucose and lipid metabolism.
  
  
  METHODS
  Duodenum-jejunum bypass (DJB), gastrojejunostomy (GJ) and sham-operations were performed on Sprague-Dawley (SD) rats. Oral glucose tolerance, insulin sensitivity, β-cell function, lipid profile, glucose-stimulated glucose-dependent insulinotropic polypeptide (GIP) levels and glucagon-like peptide-1 (GLP-1) levels were measured. The rats were observed for 24 weeks post-surgery.
  
  
  RESULTS
  Food intake and body weight were similar between the groups during the study period (P>0.05). The DJB group exhibited better glucose and lipid metabolism than the other groups (P<0.05). Compared with the GJ group, the DJB group demonstrated superior oral glucose tolerance, insulin sensitivity and lipid profiles (P<0.05); β-cell function in the two groups was similar (P>0.05). The GIP levels were decreased in the DJB group and increased in the GJ group (P<0.05), and the GLP-1 levels were increased in the DJB and GJ groups (P>0.05).
  
  
  CONCLUSIONS
  We found that foregut exclusion can prevent disordered glucose and lipid metabolism. Additionally, decreased GIP secretion was associated with improvements in glucose tolerance and insulin sensitivity, particularly related to lipid metabolism. Increased GLP-1 benefited β-cell function; however, it could not reverse the disordered glucose and lipid metabolism induced by a HFD.
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China.
authors.forename: Pengzhou
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China.
authors.forename: Liyong
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China.
authors.forename: Guohui
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China.
authors.forename: Xiangwu
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yi
authors.affiliation: Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China. Electronic address: shaihongzhu@163.com.
authors.forename: Shaihong
authors.initials: S
authors.lastname: Zhu
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D059305:Diet, High-Fat; D004386:Duodenum / Q000378:metabolism*; D005749:Gastric Inhibitory Polypeptide / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism*; D005951:Glucose Tolerance Test; D007333:Insulin Resistance; D007583:Jejunum / Q000378:metabolism*; D050356:Lipid Metabolism; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D001786:Blood Glucose; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1
keywords: Duodenum–jejunum bypass; Foregut; Gastrojejunostomy; High-fat diet