Effects of sleeve gastrectomy with jejuno-jejunal or jejuno-ileal loop on glycolipid metabolism in diabetic rats.
OBJECTIVE
To explore the effect of sleeve gastrectomy (SG) with jejuno-jejunal or jejuno-ileal loop on glycolipid metabolism in diabetic rats.


METHODS
Diabetic rats, which were induced by high-fat diet (HFD), nicotinamide and low-dose streptozotocin, underwent sham operations, SG, SG with jejuno-ileal loop (SG-JI) and SG with jejuno-jejunal loop (SG-JJ) followed by postoperative HFD. Then, at the time points of baseline and 2, 12 and 24 wk postoperatively, we determined and compared several variables, including the area under the curve for the results of oral glucose tolerance test (AUCOGTT), serum levels of triglyceride, cholesterol and ghrelin in fasting state, homeostasis model assessment of insulin resistance (HOMA-IR), body weight, calorie intake, glucagon-like peptide (GLP)-1 and insulin secretions after glucose gavage at dose of 1 g/kg.


RESULTS
At 2 wk postoperatively, rats that underwent SG, SG-JJ and SG-JI, compared with sham-operated (SHAM) rats, demonstrated lower body weight, calorie intake and ghrelin (P < 0.05 vs SHAM), enhanced secretion of insulin and GLP-1 after glucose gavage (P < 0.05 vs SHAM), improved AUCOGTT, HOMA-IR, fasting serum triglyceride and cholesterol (AUCOGTT: 1616.9 ± 83.2, 837.4 ± 83.7, 874.9 ± 97.2 and 812.6 ± 81.9, P < 0.05 vs SHAM; HOMA-IR: 4.31 ± 0.54, 2.94 ± 0.22, 3.17 ± 0.37 and 3.41 ± 0.22, P < 0.05 vs SHAM; Triglyceride: 2.35 ± 0.17, 1.87 ± 0.23, 1.98 ± 0.30 and 2.04 ± 0.21 mmol/L, P < 0.05 vs SHAM; Cholesterol: 1.84 ± 0.21, 1.53 ± 0.20, 1.52 ± 0.20 and 1.46 ± 0.23 mmol/L). At 12 wk postoperatively, rats receiving SG-JJ and SG-JI had lower body weight, reduced levels of triglyceride and cholesterol and elevated level of GLP-1 compared to those receiving SG (P < 0.05 vs SG). At 24 wk after surgery, compared with SG, the advantage of SG-JJ and SG-JI for glucolipid metabolism was still evident (P < 0.05 vs SG). SG-JI had a better performance in lipid metabolism and GLP-1 secretion of rats than did SG-JJ.


CONCLUSIONS
SG combined with intestinal loop induces better glycolipid metabolism than simple SG, with the lipid metabolism being more improved with SG-JI compared to SG-JJ.
Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, Xiang Zhang, San-Yuan Hu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
Ming-Wei
MW
Zhong
Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, Xiang Zhang, San-Yuan Hu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
Shao-Zhuang
SZ
Liu
Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, Xiang Zhang, San-Yuan Hu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
Guang-Yong
GY
Zhang
Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, Xiang Zhang, San-Yuan Hu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
Xiang
X
Zhang
Ming-Wei Zhong, Shao-Zhuang Liu, Guang-Yong Zhang, Xiang Zhang, San-Yuan Hu, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
San-Yuan
SY
Hu
D000714:Anastomosis, Surgical; D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000378:metabolism* / Q000601:surgery*; D005743:Gastrectomy; D054439:Ghrelin / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006017:Glycolipids / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D007581:Jejunoileal Bypass; D007583:Jejunum / Q000601:surgery; D051381:Rats; D017208:Rats, Wistar
D054439:Ghrelin; D006017:Glycolipids; D007328:Insulin; D052216:Glucagon-Like Peptide 1
Diabetes; Glucolipid metabolism; Jejuno-ileal loop; Jejuno-jejunal loop; Sleeve gastrectomy