Borg Cynthia M, le Roux Carel W, Ghatei Mohammad A, Bloom Stephen R, Patel Ameet G
Department of Surgery, King's College Hospital, London, UK.
Obes Surg. 2007 Sep;17(9):1193-8. doi: 10.1007/s11695-007-9211-2.
Factors leading to weight loss and weight stabilization after bariatric surgery are not fully understood. The aims of this study were to develop an animal model for biliopancreatic diversion (BPD) and to determine changes in gut hormones, malabsorption and small bowel histology postoperatively.
2 groups of Wistar rats underwent sham and BPD surgery. Daily postoperative weights and food intake were measured. 24-hour fecal collections were performed at Day 6 and 21. Bomb calorimetry was performed to determine the fecal calorific values. At day 23, levels of peptide YY (PYY), glucagon-like peptide 1 (GLP-1) and glucagon-like peptide 2 (GLP-2) were determined and small bowel biopsies were taken.
Animals in the BPD group had significant reduction in weight (P<0.001) and in food intake (P<0.001) compared to the sham group. Serum levels of PYY, GLP-1 and GLP-2 in the BPD group were significantly higher (P<0.005). Animals in the BPD group had significantly higher fecal energy content at Day 6 (P<0.001) but not at Day 21 when compared to the sham group. Small bowel histology confirmed the presence of significantly increased mitosis (P=0.03) and labelled cells (P=0.002) in the BPD animals when compared to sham.
In our animal model, the higher levels of PYY, GLP-1 and GLP-2 after BPD may be due to gut adaptation and hypertrophy and could be important in inducing and maintaining weight loss after bariatric surgery.
导致减肥手术后体重减轻和体重稳定的因素尚未完全明确。本研究的目的是建立一种胆胰转流术(BPD)的动物模型,并确定术后肠道激素的变化、吸收不良情况以及小肠组织学变化。
两组Wistar大鼠分别接受假手术和BPD手术。测量术后每日体重和食物摄入量。在第6天和第21天进行24小时粪便收集。采用弹式量热法测定粪便热值。在第23天,测定肽YY(PYY)、胰高血糖素样肽1(GLP-1)和胰高血糖素样肽2(GLP-2)的水平,并取小肠活检组织。
与假手术组相比,BPD组动物体重(P<0.001)和食物摄入量(P<0.001)显著降低。BPD组血清中PYY、GLP-1和GLP-2水平显著升高(P<0.005)。与假手术组相比,BPD组动物在第6天粪便能量含量显著更高(P<0.001),但在第21天并非如此。小肠组织学检查证实,与假手术组相比,BPD组动物有丝分裂(P=0.03)和标记细胞(P=0.002)显著增加。
在我们的动物模型中,BPD术后较高水平的PYY、GLP-1和GLP-2可能归因于肠道适应和肥大,并可能在减肥手术后诱导和维持体重减轻方面发挥重要作用。