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Shearer AM, Wang Y, Fletcher EK, Rana R, Michael ES, Nguyen N, Abdelmalek MF, Covic L, Kuliopulos A. PAR2 promotes impaired glucose uptake and insulin resistance in NAFLD through GLUT2 and Akt interference. Hepatology 2022; 76:1778-1793. [PMID: 35603482 PMCID: PMC9669194 DOI: 10.1002/hep.32589] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/28/2022] [Accepted: 05/13/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS Insulin resistance and poor glycemic control are key drivers of the development of NAFLD and have recently been shown to be associated with fibrosis progression in NASH. However, the underlying mechanisms involving dysfunctional glucose metabolism and relationship with NAFLD/NASH progression remain poorly understood. We set out to determine whether protease-activated receptor 2 (PAR2), a sensor of extracellular inflammatory and coagulation proteases, links NAFLD and NASH with liver glucose metabolism. APPROACH AND RESULTS Here, we demonstrate that hepatic expression of PAR2 increases in patients and mice with diabetes and NAFLD/NASH. Mechanistic studies using whole-body and liver-specific PAR2-knockout mice reveal that hepatic PAR2 plays an unexpected role in suppressing glucose internalization, glycogen storage, and insulin signaling through a bifurcating Gq -dependent mechanism. PAR2 activation downregulates the major glucose transporter of liver, GLUT2, through Gq -MAPK-FoxA3 and inhibits insulin-Akt signaling through Gq -calcium-CaMKK2 pathways. Therapeutic dosing with a liver-homing pepducin, PZ-235, blocked PAR2-Gq signaling and afforded significant improvements in glycemic indices and HbA1c levels in severely diabetic mice. CONCLUSIONS This work provides evidence that PAR2 is a major regulator of liver glucose homeostasis and a potential target for the treatment of diabetes and NASH.
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Affiliation(s)
- Andrew M. Shearer
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
- Tufts University School of Graduate Biomedical Sciences/DMCB, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Yanling Wang
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
| | - Elizabeth K. Fletcher
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
| | - Rajashree Rana
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
| | - Emily S. Michael
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
| | - Nga Nguyen
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
| | - Manal F. Abdelmalek
- Division of Gastroenterology and Hepatology, Duke University Medical Center, Durham, North Carolina, USA
| | - Lidija Covic
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
- Tufts University School of Graduate Biomedical Sciences/DMCB, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Athan Kuliopulos
- Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Boston, Massachusetts, USA
- Tufts University School of Graduate Biomedical Sciences/DMCB, Tufts University School of Medicine, Boston, Massachusetts, USA
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Guan W, Cui Y, Bu H, Liu J, Zhao S, Zhao Q, Ma X. Duodenal-Jejunal Exclusion Surgery Improves Type 2 Diabetes in a Rat Model Through Regulation of Early Glucose Metabolism. Can J Diabetes 2020; 44:401-406.e1. [PMID: 32279935 DOI: 10.1016/j.jcjd.2020.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/25/2018] [Accepted: 12/07/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Metabolic surgery has been proven to be widely effective for the control of glucose and weight in patients with type 2 diabetes and obesity. However, the effects of bariatric surgery on nonobesity type 2 diabetes and its metabolism are still unclear. This study aimed to measure the effects of duodenal-jejunal exclusion on glycometabolism in nonobese rats with type 2 diabetes and to investigate its mechanisms. METHODS Goto-Kakizaki rats and Sprague-Dawley rats were divided into duodenal-jejunal exclusion operation groups and sham operation groups, respectively. The glucose-relative parameters were measured before and after operation. Eight weeks postoperation, the levels of the key regulators of intestinal gluconeogenesis and the crucial proteins of hepatic insulin signalling were evaluated. RESULTS Postoperatively, the concentrations of blood glucose declined, and the insulin sensitivity increased significantly in rats with diabetes. However, there was no obvious reduction in weight. Eight weeks postoperatively, the mRNA levels of glucose-6-phosphatase and phosphoenolpyruvate pyruvate kinase in the jejunum and the levels of insulin receptor substrate-2 and glucose transporter-2 in the liver were significantly increased compared with the rats that had undergone the sham operation. CONCLUSIONS Duodenal-jejunal exclusion surgery is an effective procedure for improving glucose metabolism independent of weight loss in nonobese rats with diabetes. The molecular mechanisms might be associated with a series of processes, including intestinal gluconeogenesis and the hepatic insulin signaling pathway.
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Affiliation(s)
- Wei Guan
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuliang Cui
- Department of Endocrinology, the Dezhou People's Hospital, Dezhou, China
| | - Hemei Bu
- Department of Nutriology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Liu
- Department of Endocrinology, the Dezhou People's Hospital, Dezhou, China
| | - Sha Zhao
- Department of Nutriology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qing Zhao
- Department of Endocrinology, the Dezhou People's Hospital, Dezhou, China
| | - Xianghua Ma
- Department of Nutriology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Arima N, Sasaki Y, Lee LH, Zhang H, Figueiredo JL, Mlynarchik AK, Qiao J, Yamada I, Higashi H, Ha AH, Halu A, Mizuno K, Singh SA, Yamazaki Y, Aikawa M. Multiorgan Systems Study Reveals Igfbp7 as a Suppressor of Gluconeogenesis after Gastric Bypass Surgery. J Proteome Res 2020; 19:129-143. [PMID: 31661273 DOI: 10.1021/acs.jproteome.9b00441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Roux-en-Y gastric bypass (RYGB) surgery reduces weight in obese patients. A marked decrease in blood glucose levels occurs before weight loss; however, key molecules that improve the glycemic profile remain largely unknown. Using a murine RYGB surgery model, we performed multiorgan proteomics and bioinformatics to monitor the proteins and molecular pathways that change in this early glycemic response. Multiplexed proteomic kinetics data analysis revealed that the Roux limb, biliopancreatic limb, liver, and pancreas each exhibited unique temporal and molecular responses to the RYGB surgery. In addition, protein-protein network analysis indicated that the changes to the microbial environment in the intestine may play a crucial role in the beneficial effects of RYGB surgery. Furthermore, insulin-like growth factor binding protein 7 (Igfbp7) was identified as an early induced protein in the Roux limb. Known secretory properties of Igfbp7 prompted us to further investigate its role as a remote organ regulator of glucose metabolism. Igfbp7 overexpression decreased blood glucose levels in diet-induced obese mice and attenuated gluconeogenic gene expression in the liver. Secreted Igfbp7 appeared to mediate these beneficial effects. These results demonstrate that organs responded differentially to RYGB surgery and indicate that Igfbp7 may play an important role in improving blood glucose levels.
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Affiliation(s)
- Naoaki Arima
- Tokyo New Drug Research Laboratories , Kowa Company, Ltd. , Tokyo 189-0022 , Japan
| | - Yusuke Sasaki
- Tokyo New Drug Research Laboratories , Kowa Company, Ltd. , Tokyo 189-0022 , Japan
| | | | | | | | | | | | - Iwao Yamada
- Tokyo New Drug Research Laboratories , Kowa Company, Ltd. , Tokyo 189-0022 , Japan
| | - Hideyuki Higashi
- Tokyo New Drug Research Laboratories , Kowa Company, Ltd. , Tokyo 189-0022 , Japan
| | | | | | - Ken Mizuno
- Tokyo New Drug Research Laboratories , Kowa Company, Ltd. , Tokyo 189-0022 , Japan
| | | | - Yukiyoshi Yamazaki
- Tokyo New Drug Research Laboratories , Kowa Company, Ltd. , Tokyo 189-0022 , Japan
| | - Masanori Aikawa
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health , Moscow , Russian Federation , 119146
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4
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Residual Gastric Dilatation Interferes with Metabolic Improvements Following Sleeve Gastrectomy by Upregulating the Expression of Sodium-Glucose Cotransporter-1. Obes Surg 2019; 29:3324-3333. [DOI: 10.1007/s11695-019-03997-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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5
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Additional effects of duodenojejunal bypass on glucose metabolism in a rat model of sleeve gastrectomy. Surg Today 2019; 49:637-644. [DOI: 10.1007/s00595-019-1772-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/12/2019] [Indexed: 02/07/2023]
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Akalestou E, Genser L, Villa F, Christakis I, Chokshi S, Williams R, Rubino F. Establishing a successful rat model of duodenal- jejunal bypass: A detailed guide. Lab Anim 2018; 53:362-371. [PMID: 30227760 DOI: 10.1177/0023677218797370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Gastric bypass surgery, an operation that restricts the stomach and bypasses the duodenum and part of the jejunum, results in major improvement or remission of type 2 diabetes. Duodenual-jejunal bypass was developed by one of the authors (FR) as an experimental, stomach-sparing variant of gastric bypass surgery to investigate weight-independent mechanisms of surgical control of diabetes. Duodenual-jejunal bypass has been shown to improve various aspects of glucose homeostasis in rodents and in humans, thus providing an experimental model for investigating mechanisms of action of surgery and elusive aspects of gastrointestinal physiology. Performing duodenual-jejunal bypass in rodents, however, is associated with a steep learning curve. Here we report our experience with duodenual-jejunal bypass and provide practical tips for successful surgery in rats. Duodenual-jejunal bypass was performed on 50 lean rats as part of a study aimed at investigating the effect of the procedure on the physiologic mechanisms of glucose homeostasis. During the study, we have progressively refined details of anatomic exposure, technical aspects of duodeno-jejunostomy and peri-operative care. We analysed the role of such refinements in improving operative time and post-operative mortality. We found that refinement of exposure methods of the gastro-duodenal junction aimed at minimizing tension on small visceral vasculature, technical aspects of duodeno-jejunal anastomosis and peri-operative management played a major role in improving the survival rate and operative time. Overall, an experimental model of duodenual-jejunal bypass was successfully reproduced. Based on this experience, we describe here what we believe are the most important technical tips to reduce the learning curve for the procedure.
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Affiliation(s)
- Elina Akalestou
- 1 Division of Diabetes and Nutritional Sciences, King's College London, UK.,2 Institute of Hepatology London, Foundation for Liver Research, London, UK.,3 Division of Transplantation, Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Laurent Genser
- 1 Division of Diabetes and Nutritional Sciences, King's College London, UK.,4 Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Francesco Villa
- 1 Division of Diabetes and Nutritional Sciences, King's College London, UK.,4 Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Ioannis Christakis
- 4 Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Shilpa Chokshi
- 2 Institute of Hepatology London, Foundation for Liver Research, London, UK.,3 Division of Transplantation, Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Roger Williams
- 2 Institute of Hepatology London, Foundation for Liver Research, London, UK.,3 Division of Transplantation, Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Francesco Rubino
- 1 Division of Diabetes and Nutritional Sciences, King's College London, UK.,4 Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
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Cohen R, Caravatto PP, Petry TZ. Innovative metabolic operations. Surg Obes Relat Dis 2016; 12:1247-55. [DOI: 10.1016/j.soard.2016.02.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/23/2016] [Indexed: 02/07/2023]
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Amelioration of glycemic control by sleeve gastrectomy and gastric bypass in a lean animal model of type 2 diabetes: restoration of gut hormone profile. Obes Surg 2015; 25:7-18. [PMID: 24902653 DOI: 10.1007/s11695-014-1309-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND In obese diabetic patients, bariatric surgery has been shown to induce remission of type 2 diabetes. Along with weight loss itself, changes in gut hormone profiles after surgery play an important role in the amelioration of glycemic control. However, the potential of gastrointestinal surgery regarding diabetes remission in non-severely obese diabetic patients has yet to be defined. In the present experimental study, we explored the effect of established bariatric procedures with and without duodenal exclusion on glycemic control and gut hormone profile in a lean animal model of type 2 diabetes. METHODS Forty 12- to 14-week-old non-obese diabetic Goto-Kakizaki (GK) rats were randomly assigned to four groups: control group (GKC), sham surgery (GKSS), sleeve gastrectomy (GKSG), and gastric bypass (GKGB). Age-matched Wistar rats served as a non-diabetic control group (WIC). Glycemic control and plasma lipids were assessed at the beginning of the observation period and 4 weeks after surgery. Fasting and mixed meal-induced plasma levels of ghrelin, glucagon-like peptide-17-36 (GLP-1), and peptide tyrosine-tyrosine (PYY) were measured. RESULTS In GK rats, glycemic control improved after sleeve gastrectomy (SG) and gastric bypass (GB). Mixed meal-induced gut hormone profiles in Wistar rats (WIC) were significantly different from those of sham-operated or control group GK rats. After SG and GB, GK rats showed a similar postprandial decrease in ghrelin as observed in non-diabetic WIC. Following both surgical procedures, a significant meal-induced increase in PYY and GLP-1 could be demonstrated. CONCLUSIONS SG and GB induce a similar improvement in overall glycemic control in lean diabetic rodents. Meal-induced profiles of ghrelin, GLP-1, and PYY in GK rats are significantly modified by SG and GB and become similar to those of non-diabetic Wistar rats. Our data do not support the hypothesis that duodenal exclusion and early contact of food with the ileal mucosa alone explain changes in gut hormone profile in GK rats after gastrointestinal surgery.
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Duodenal-jejunal exclusion improves insulin resistance in type 2 diabetic rats by upregulating the hepatic insulin signaling pathway. Nutrition 2015; 31:733-9. [DOI: 10.1016/j.nut.2014.10.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 09/14/2014] [Accepted: 10/22/2014] [Indexed: 12/19/2022]
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Eickhoff H, Louro T, Matafome P, Seiça R, Castro e Sousa F. Glucagon secretion after metabolic surgery in diabetic rodents. J Endocrinol 2014; 223:255-65. [PMID: 25274989 DOI: 10.1530/joe-14-0445] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Excessive or inadequate glucagon secretion promoting hepatic gluconeogenesis and glycogenolysis is believed to contribute to hyperglycemia in patients with type 2 diabetes. Currently, metabolic surgery is an accepted treatment for obese patients with type 2 diabetes and has been shown to improve glycemic control in Goto-Kakizaki (GK) rats, a lean animal model for type 2 diabetes. However, the effects of surgery on glucagon secretion are not yet well established. In this study, we randomly assigned forty 12- to 14-week-old GK rats to four groups: control group (GKC), sham surgery (GKSS), sleeve gastrectomy (GKSG), and gastric bypass (GKGB). Ten age-matched Wistar rats served as a non-diabetic control group (WIC). Glycemic control was assessed before and 4 weeks after surgery. Fasting- and mixed-meal-induced plasma levels of insulin and glucagon were measured. Overall glycemic control improved in GKSG and GKGB rats. Fasting insulin levels in WIC rats were similar to those for GKC or GKSS rats. Fasting glucagon levels were highest in GKGB rats. Whereas WIC, GKC, and GKSS rats showed similar glucagon levels, without any significant meal-induced variation, a significant rise occurred in GKSG and GKGB rats, 30 min after a mixed meal, which was maintained at 60 min. Both GKSG and GKGB rats showed an elevated glucagon:insulin ratio at 60 min in comparison with all other groups. Surprisingly, the augmented post-procedural glucagon secretion was accompanied by an improved overall glucose metabolism in GKSG and GKGB rats. Understanding the role of glucagon in the pathophysiology of type 2 diabetes requires further research.
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Affiliation(s)
- Hans Eickhoff
- Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Teresa Louro
- Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Paulo Matafome
- Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Raquel Seiça
- Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
| | - Francisco Castro e Sousa
- Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal Obesity CenterHospital de Santiago, EN 10, km 37, 2900-722 Setubal, PortugalFaculty of MedicineInstitutes of PhysiologyBiomedical Imaging and Life Sciences (IBILI)University of Coimbra, Polo III, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, PortugalDepartment of Surgery AUniversity Hospital of Coimbra, Rua Fonseca Pinto, 3000-075 Coimbra, PortugalFaculty of MedicineUniversity of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
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Bonfleur ML, Ribeiro RA, Pavanello A, Soster R, Lubaczeuski C, Cezar Faria Araujo A, Boschero AC, Balbo SL. Duodenal-Jejunal Bypass Restores Insulin Action and Βeta-Cell Function in Hypothalamic-Obese Rats. Obes Surg 2014; 25:656-65. [DOI: 10.1007/s11695-014-1427-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Effects of duodenal switch alone or in combination with sleeve gastrectomy on body weight and lipid metabolism in rats. Nutr Diabetes 2014; 4:e124. [PMID: 24979153 PMCID: PMC4079930 DOI: 10.1038/nutd.2014.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 05/10/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A combined procedure of sleeve gastrectomy and duodenal switch (SG+DS) has been applied to the treatment of super obesity. The aim of the present study was to test whether duodenal switch alone (DS) leads to similar weight loss and changes in lipid metabolism as SG+DS. METHODS Male Sprague-Dawley rats underwent sham surgery (Sham, N=7), duodenal switch alone (DS, N=5) or sleeve gastrectomy followed by duodenal switch (SG+DS, N=5). Body weight, feed and water intakes, and ambulatory activity were recorded 2 months post surgery. Tissue and faecal lipids, faecal bile acids, plasma cytokines and lipid metabolism-related gene expression in adipose tissue and liver were analysed. RESULTS Daily energy intake, relative feed uptake, ambulatory activity and body weight reduction were similar between DS and SG+DS rats. The hepatic triacylglycerol content was higher and faecal secretion of triacylglycerol was lower after SG+DS compared to DS (P<0.05). Faecal bile acid secretion was higher in SG+DS than in DS rats (P<0.05) despite similar hepatic CYP7A1mRNA level. Plasma levels of proinflammatory cytokines interleukin (IL)-1b, IL-2, IL-4, IL-5, IL-6, IL-12, granulocyte-macrophage colony stimulating factor and tumour necrosis factor alpha were higher in SG+DS than in DS rats (P<0.05). CONCLUSIONS Although DS and SG+DS had similar efficacy in terms of body weight loss, SG+DS resulted in a poorer regulation of lipid metabolism than DS.
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Duodenal–Jejunal Bypass Surgery Up-Regulates the Expression of the Hepatic Insulin Signaling Proteins and the Key Regulatory Enzymes of Intestinal Gluconeogenesis in Diabetic Goto–Kakizaki Rats. Obes Surg 2013; 23:1734-42. [DOI: 10.1007/s11695-013-0985-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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