title: Malabsorption and intestinal adaptation after one anastomosis gastric bypass compared with Roux-en-Y gastric bypass in rats.
abstract: The technically easier one-anastomosis (mini) gastric bypass (MGB) is associated with similar metabolic improvements and weight loss as the Roux-en-Y gastric bypass (RYGB). However, MGB is controversial and suspected to result in greater malabsorption than RYGB. In this study, we compared macronutrient absorption and intestinal adaptation after MGB or RYGB in rats. Body weight and food intake were monitored and glucose tolerance tests were performed in rats subjected to MGB, RYGB, or sham surgery. Carbohydrate, protein, and lipid absorption was determined by fecal analyses. Intestinal remodeling was evaluated by histology and immunohistochemistry. Peptide and amino acid transporter mRNA levels were measured in the remodeled intestinal mucosa and those of anorexigenic and orexigenic peptides in the hypothalamus. The MGB and RYGB surgeries both resulted in a reduction of body weight and an improvement of glucose tolerance relative to sham rats. Hypothalamic orexigenic neuropeptide gene expression was higher in MGB rats than in RYGB or sham rats. Fecal losses of calories and proteins were greater after MGB than RYGB or sham surgery. Intestinal hyperplasia occurred after MGB and RYGB with increased jejunum diameter, higher villi, and deeper crypts than in sham rats. Peptidase and peptide or amino acid transporter genes were overexpressed in jejunal mucosa from MGB rats but not RYGB rats. In rats, MGB led to greater protein malabsorption and energy loss than RYGB. This malabsorption was not compensated by intestinal overgrowth and increased expression of peptide transporters in the jejunum.
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France;
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Cavin
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France;
authors.forename: Eglantine
authors.initials: E
authors.lastname: Voitellier
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France;
authors.forename: Françoise
authors.initials: F
authors.lastname: Cluzeaud
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière-Charles Foix, Département de Coprologie Fonctionnelle, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Kapel
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France; Service de Chirurgie Générale et Digestive, AP-HP Hôpital Bichat Claude Bernard, Paris, France;
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marmuse
authors.affiliation: Service de Chirurgie Digestive, AP-HP Hôpital Européen Georges Pompidou, Paris, et Université Paris Descartes, Sorbonne Paris Cité, France; and.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chevallier
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France; Service de Chirurgie Digestive, AP-HP Hôpital Louis Mourier, Colombes, France;
authors.forename: Simon
authors.initials: S
authors.lastname: Msika
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France;
authors.forename: André
authors.initials: A
authors.lastname: Bado
authors.affiliation: Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France; maude.le-gall@inserm.fr.
authors.forename: Maude
authors.identifier: 0000-0002-5372-4585
authors.initials: M
authors.lastname: Le Gall
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000818:Animals; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods*; D005786:Gene Expression Regulation; D018149:Glucose Intolerance; D007422:Intestines / Q000502:physiology*; D008286:Malabsorption Syndromes / Q000209:etiology*; D009479:Neuropeptides / Q000235:genetics / Q000378:metabolism; D051381:Rats; D015431:Weight Loss
chemical_list: D009479:Neuropeptides
keywords: Roux-en-Y gastric bypass; bariatric surgery; intestinal adaptation; macronutrient absorption; mini-gastric bypass