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Obes Surg. 2016 Apr;26(4):797-804. doi: 10.1007/s11695-015-1811-7.

Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model.

Author information

1
Department of General Surgery, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092, China.
2
Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China.
3
Department of General Surgery, Oakwood Southshore Medical Center, Trenton, MI, USA.
4
Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China. zhujiangfan@hotmail.com.

Abstract

BACKGROUND:

Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

METHODS:

Forty 10-week-old male Zucker diabetic fatty rats were randomly assigned to four groups: control, SG, JI-SG, and RYGB. Their body weights, food intake, and levels of gut hormones (ghrelin, insulin, and glucagon-like peptide-1 (GLP-1)) and lipids were measured.

RESULTS:

Rats in the SG, JI-SG, and RYGB groups demonstrated lower food intake and more weight loss 2 weeks postoperatively compared with control rats. Furthermore, rats in the JI-SG group achieved more weight loss (mean 242.7 ± 11.2 g) compared with those in the SG and RYGB groups (SG, 401.4 ± 15.1 g and RYGB, 298 ± 12 g, both P < 0.01). All surgery groups demonstrated a decreased fasting insulin, serum glucose, lipid levels, and increased GLP-1 postoperatively. The JI-SG group had lower fasting ghrelin levels than the RYGB group (168 ± 19.8 ng/L vs. 182 ± 16.7 ng/L, P < 0.01) and higher fasting GLP-1 levels than the SG group (1.99 ± 0.11 pmol/L vs. 1.71 ± 0.12 pmol/L, P < 0.01) at 12 weeks postoperatively. Over the experimental period, the ghrelin levels slowly increased in all surgical groups but remained lower than the preoperative and control levels.

CONCLUSIONS:

JI-SG induced higher ghrelin and GLP-1 levels and improved glycemic control in Zucker diabetic fatty rats. Compared with SG and RYGB, JI-SG appeared to be a simple, relatively safe, and more effective procedure for treating type 2 diabetes and obesity in this animal model.

KEYWORDS:

Jejunoileal anastomosis; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type 2 diabetes; Zucker diabetic fatty rat

PMID:
26202420
DOI:
10.1007/s11695-015-1811-7
[Indexed for MEDLINE]

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