Dolo PR, Li C, Zhu X, Yao L, Meng S, Hong J. The effect of distal-ileal exclusion after Roux-en-Y gastric bypass on glucose tolerance and GLP-1 response in type-2 diabetes Sprague-Dawley rat model.
Surg Obes Relat Dis 2018;
14:1552-1560. [PMID:
30122358 DOI:
10.1016/j.soard.2018.07.009]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/01/2018] [Accepted: 07/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND
An increase in glucagon-like peptide-1 (GLP-1) mediating early diabetes remission after Roux-en-Y gastric bypass (RYGB) is believed to be associated with distal-ileal stimulation.
OBJECTIVE
To observe the effect of distal-ileal exclusion on glucose tolerance and GLP-1 response after RYGB.
SETTING
Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
METHODS
A type 2 diabetes model was created in 40 Sprague-Dawley rats that were randomly assigned to a RYGB group (n = 32) and a sham group (n = 8). Four weeks after surgery, the RYGB group was further divided into the RYGB control group (n = 8) and the distal-ileal exclusion group (RYGB-IEx, n = 24). Rats in the RYGB-IEx group underwent laparotomy, and the last 20 cm of ileum was excluded. An oral glucose tolerance test, insulin tolerance test, and mixed-meal tolerance test conducted preoperatively were repeated in all groups at 4 and 8 weeks postoperatively.
RESULTS
Compared with preoperative level, GLP-1 was significantly increased after RYGB. GLP-1 area under the curve recorded after oral gavage at week 4 postoperatively was significantly higher than the preoperative level (P < .05). GLP-1, insulin area under the curve, and improved glucose-excursion on oral glucose tolerance test 4 weeks after gastric bypass were not reversed at week 8 after distal-ileal exclusion in the RYGB-IEx group. Food intake increased significantly after distal-ileal exclusion in the RYGB-IEx group.
CONCLUSION
These findings suggest that distal-ileal stimulation might not be required for incretin response and diabetes remission after gastric bypass in the type 2 diabetes Sprague-Dawley rat model.
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