Department of Urology, Center for the Study of Lithiasis and Pathological Calcification, University of Florida, Gainesville, Florida, USA.
Nutrition. 2012 Jan;28(1):76-80. doi: 10.1016/j.nut.2011.03.003. Epub 2011 Jul 1.
Roux-en-Y gastric bypass (RYGB) surgery is the most common surgical intervention for long-term weight loss in morbidly obese patients. By decreasing obesity-associated hyperfiltration, diabetes, and hypertension, RYGB is touted to stabilize, if not prevent, progression of chronic renal disease. To test this, the renal histology of diet-induced obese rats that underwent RYGB surgery was compared with that of pair-fed and sham obese controls.
Sprague-Dawley rats, fed a high-fat, low-oxalate diet to induce gross obesity, were randomized to RYGB (n = 6), gastrointestinal-intact sham-operated obese controls (sham, n = 4), or gastrointestinal-intact sham-operated obese pair-fed controls (fed, n = 8). Daily body weight and food intake were recorded. On postoperative day 42, renal histology and immunohistochemistry were examined. Renal pathology was assessed by a categorical glomerular lesion score and a quantitative glomerular/tubular scoring system by experienced veterinary pathologists. Osteopontin and ED-1 (monocyte/macrophage cell) stainings were estimated by the percentage of stained area and the number of counted cells/high-power field, respectively.
Compared with sham and fed controls, RYGB rats had significant decreases in body weight (P < 0.001), more glomerular lesions (P = 0.02), and received higher glomerular and tubular lesion scores (P < 0.01). RYGB rodents had significantly stronger staining for osteopontin within the inner medullary region (P < 0.005) and ED-1 within the outer medullary region (P < 0.02) compared with sham and fed controls.
In this diet-induced obese rat model, RYGB is associated with chronic glomerulosclerosis and tubulointerstitial nephritis, confirmed by histology and immunohistochemistry. Prospective studies to better define the injurious mechanisms in this model are underway.
Roux-en-Y 胃旁路（RYGB）手术是治疗病态肥胖患者长期减肥的最常见手术干预措施。通过减少肥胖相关的高滤过、糖尿病和高血压，RYGB 被吹捧为稳定（如果不能预防）慢性肾脏病的进展。为了验证这一点，比较了接受 RYGB 手术的饮食诱导肥胖大鼠的肾脏组织学与配对喂养和假肥胖对照组的组织学。
Sprague-Dawley 大鼠喂食高脂肪、低草酸盐饮食以诱导明显肥胖，随机分为 RYGB（n = 6）、胃肠道完整假手术肥胖对照组（sham，n = 4）或胃肠道完整假手术肥胖配对喂养对照组（fed，n = 8）。记录每日体重和食物摄入量。术后第 42 天，检查肾脏组织学和免疫组织化学。肾脏病理通过经验丰富的兽医病理学家进行分类肾小球病变评分和定量肾小球/肾小管评分系统进行评估。通过染色面积百分比和每个高倍视野计数的细胞数分别估计骨桥蛋白和 ED-1（单核/巨噬细胞）染色。
与 sham 和 fed 对照组相比，RYGB 大鼠体重明显下降（P < 0.001），肾小球病变更严重（P = 0.02），肾小球和肾小管病变评分更高（P < 0.01）。与 sham 和 fed 对照组相比，RYGB 啮齿动物的内髓质区域的骨桥蛋白染色（P < 0.005）和外髓质区域的 ED-1 染色（P < 0.02）明显更强。
在这种饮食诱导的肥胖大鼠模型中，RYGB 与组织学和免疫组织化学证实的慢性肾小球硬化和肾小管间质性肾炎有关。正在进行前瞻性研究以更好地定义该模型中的损伤机制。
