Small Intestinal Bypass Induces a Persistent Weight-Loss Effect and Improves Glucose Tolerance in Obese Rats.
This study investigated the role of proximal small intestinal bypass (PSIB) and distal small intestinal bypass (DSIB) as well as their long-term effects on weight loss and glucose metabolism in high-sugar and high-fat diet-induced obese rats.



Sprague-Dawley rats were divided into four groups: PSIB, bypassing 60% of the proximal small intestine length; DSIB, bypassing 60% of the distal small intestine length; sham-operated (Sham) animals; and control animals. All rats were fed a high-sugar and high-fat diet after surgery. The primary outcome measures were body weight, food intake, fasting blood glucose (FBG) levels, oral glucose tolerance test (OGTT), and the insulin tolerance test (ITT).



Global body weight (BW) and food intake in the PSIB and DSIB groups were lower than those in the Sham group at postoperative week 2. BW and food intake in the PSIB group were lower than those in the DSIB group at postoperative week 24. The PSIB and DSIB groups exhibited improvement in glucose tolerance at postoperative weeks 4, 8, and 24. The PSIB and DSIB groups exhibited improvement in FBG at postoperative week 24, and only the DSIB group exhibited improvement in insulin sensitivity.



This study provides experimental evidence that PSIB surgery induced a better and more persistent weight loss effect than DSIB surgery and that the two types of intestinal bypass surgeries yielded equivalent and stable long-term improvement in glucose tolerance in an obese rat model.
Department of General Surgery, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, Jiangxi Province, 330006, People's Republic of China.
Jiaqing
J
Cao
Department of General Surgery, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, Jiangxi Province, 330006, People's Republic of China.
Quan
Q
Ren
Department of Women's Health, Maternal and Child Health Hospital of Jiangxi Province, Nanchang, 330006, China.
Cai
C
Tan
Department of General Surgery, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, Jiangxi Province, 330006, People's Republic of China. jinyuan201314@outlook.com.
Jinyuan
J
Duan
D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D000070601:Diet, Carbohydrate Loading; D059305:Diet, High-Fat; D004195:Disease Models, Animal; D004435:Eating; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D007333:Insulin Resistance; D007581:Jejunoileal Bypass / Q000379:methods*; D008297:Male; D009765:Obesity / Q000503:physiopathology / Q000601:surgery*; D051381:Rats; D017207:Rats, Sprague-Dawley; D015431:Weight Loss
D001786:Blood Glucose
Bariatric surgery; Distal small intestinal bypass; Glucose homeostasis; PYY; Proximal small intestinal bypass