Mendieta-Zerón Hugo, Larrad-Jiménez Alvaro, Frühbeck Gema, Da Boit Katia, Diéguez C
Department of Physiology, University of Santiago de Compostela , Santiago de Compostela, Spain.
Obes Surg. 2009 Apr;19(4):484-9. doi: 10.1007/s11695-008-9710-9. Epub 2008 Oct 15.
Existing medical therapeutic strategies to achieve and maintain clinically significant weight loss in morbid obesity remain limited and the biliopancreatic diversion (BPD) is still the most effective among the bariatric surgical procedures. Our objective was to evaluate the weight and food intake after this procedure in a rat model.
Rats randomly underwent one of the following protocols (1) BPD (n = 12) versus sham (n = 12) with a follow-up period of 30 days and (2) BPD (n = 4) versus pair-fed (PF; n = 4) with a follow-up period of 50 days. Under intraperitoneal anesthesia with ketamine-xilacine, a subcardinal corpo-antral gastrectomy was made, preserving the gastric fundus that was anastomosed to a jejunal limb after dissecting the proximal jejunum 5 cm below the ligament of Treitz to form the alimentary limb. The biliopancreatic limb was terminolaterally anastomosed to the distal ileum 5 cm above the ileocecal valve to form the common limb. Sham animals underwent only abdominal incision. Weight and food intake were measured every day.
In protocol 1, after postoperative day 30, BPD rats exhibited a mean weight reduction of 17.9% while shams increased 12.4%. There was no difference in food intake adjusted per 100 g of body weight. In protocol 2, after postoperative day 50, BPD rats had a mean weight reduction of 22.6% and, despite increasing their caloric intake from a mean of 42.6 after 6 days to 65.8 kcal/day after 50 days, they kept a similar mean weight of 344.0 and 340.2 g, respectively; on the contrary, PF rats exhibited a 30.8% body weight gain.
After the BPD, body weight is maintained independently of changes in food and energy intake.
现有的实现并维持病态肥胖患者临床上显著体重减轻的医学治疗策略仍然有限,而胆胰分流术(BPD)仍是减肥手术中最有效的方法。我们的目的是在大鼠模型中评估该手术后的体重和食物摄入量。
大鼠随机接受以下方案之一:(1)BPD组(n = 12)与假手术组(n = 12),随访30天;(2)BPD组(n = 4)与配对喂养组(PF;n = 4),随访50天。在氯胺酮-西拉嗪腹腔麻醉下,进行次全胃体窦切除术,保留胃底,在Treitz韧带下方5 cm处解剖近端空肠后,将胃底与空肠段吻合形成消化道肢体。胆胰肢体在回盲瓣上方5 cm处与远端回肠端侧吻合形成共同肢体。假手术动物仅进行腹部切口。每天测量体重和食物摄入量。
在方案1中,术后30天,BPD大鼠平均体重减轻17.9%,而假手术组体重增加12.4%。每100 g体重调整后的食物摄入量无差异。在方案2中,术后50天,BPD大鼠平均体重减轻22.6%,尽管其热量摄入从6天后的平均42.6 kcal增加到50天后的65.8 kcal/天,但它们的平均体重分别保持在344.0 g和340.2 g左右;相反,PF大鼠体重增加了30.8%。
BPD术后,体重维持与食物和能量摄入的变化无关。