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J Gastrointest Surg. 2008 Nov;12(11):1854-64; discussion 1864-5. doi: 10.1007/s11605-008-0666-9. Epub 2008 Sep 3.

Mechanisms of ileal adaptation for glucose absorption after proximal-based small bowel resection.

Author information

1
Gastrointestinal Research Unit and Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.

Abstract

INTRODUCTION:

The hexose transmembrane transporters SGLT1 and GLUT2 are present in low quantities in ileum where little glucose absorption occurs normally; however, glucose uptake in ileum is highly adaptable after small bowel resection.

HYPOTHESIS:

Ileal adaptability for glucose absorption after jejunal resection is mediated predominately by upregulation of GLUT2.

METHODS:

Rats underwent 70% proximal-based jejunoileal resection. Transporter-mediated glucose uptake was measured in proximal and distal remnant ileum 1 and 4 wk postoperatively (n = 6 rats, each) and in corresponding ileal segments in control and 1 wk sham laparotomy rats (n = 6, each) without and with selective inhibitors of SGLT1 and GLUT2. In separate groups of rats (n = 6, each), protein (Western blots), mRNA (reverse transcriptase polymerase chain reaction [RT-PCR]), and villus height (histomorphology) were measured.

RESULTS:

After 70% proximal intestinal resection, there was no dramatic change in protein or mRNA expression per cell of either SGLT1 or GLUT2, but median glucose uptake (nmol/cm/min) increased markedly from 52 (range 28-63) in controls to 118 (range 80-171) at 1 wk, and 203 (range 93-248) at 4 wk (p < or = 0.04 each) correlating with change in villus height (p < or = 0.03).

CONCLUSIONS:

Ileal adaptation for glucose transport occurs through cellular proliferation (hyperplasia) and not through cellular upregulation of glucose transporters.

PMID:
18766411
PMCID:
PMC2743989
DOI:
10.1007/s11605-008-0666-9
[Indexed for MEDLINE]
Free PMC Article

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