Endocrine Research Unit, Medizinische Klinik Innenstadt, LMU, Ziemssenstr 1, 80336 Munich, Germany.
Obes Surg. 2012 Jan;22(1):140-51. doi: 10.1007/s11695-011-0528-5.
Vertical sleeve gastrectomy (VSG) effectively reduces body weight (BW) in obese rats and humans. However, post-surgical weight regain is frequently observed in subjects after VSG, but the underlying reasons remain poorly understood. We therefore investigated if post-surgical consumption of different diets can affect the outcome of VSG.
VSG or sham operation was performed in Long-Evans rats with diet-induced obesity (n = 37). After post-surgical recovery, rats were fed ad libitum either with standard chow (CH), high-fat (HF) or low-carbohydrate, high-fat (LCHF) diets. BW and food intake were measured every second day; serum leptin, cholesterol, HDL cholesterol, and triglycerides were analyzed 4 weeks after surgery. Energy expenditure and locomotor activity were determined by a combined indirect calorimetry system, lean and fat mass by nuclear magnetic resonance.
After 4 weeks, BW gain, fat mass, and leptin were lower in VSG rats when compared to sham controls (p < 0.05). Energy expenditure and locomotor activity were not affected by VSG indicating that weight reduction derives from the significantly lower cumulative 4-week energy intake in VSG compared to sham. Sham rats fed LCHF consumed the most energy, followed by rats fed HF. In contrast, after VSG cumulative energy intake was highest in rats fed HF, but not different between CH and LCHF. Consistently, post-surgical BW and fat mass regain were highest in the HF-VSG group. Lipid profiles were improved by VSG but not differentially affected by diets.
In conclusion, consumption of a HF diet but not the more energy-dense LCHF diet reduced the effectiveness of VSG in rats.
垂直袖状胃切除术（VSG）可有效减轻肥胖大鼠和人类的体重（BW）。然而，在 VSG 手术后，患者经常会出现体重反弹的情况，但背后的原因仍知之甚少。因此，我们研究了手术后不同饮食的摄入是否会影响 VSG 的结果。
对饮食诱导肥胖的 Long-Evans 大鼠进行 VSG 或假手术（n = 37）。手术后恢复后，大鼠自由进食标准饲料（CH）、高脂肪（HF）或低碳水化合物、高脂肪（LCHF）饮食。每两天测量一次 BW 和食物摄入量；手术后 4 周分析血清瘦素、胆固醇、高密度脂蛋白胆固醇和甘油三酯。通过联合间接测热法系统测定能量消耗和运动活性，通过核磁共振测定瘦体重和脂肪量。
4 周后，与假手术对照组相比，VSG 大鼠的 BW 增加、脂肪量和瘦素降低（p < 0.05）。VSG 并未影响能量消耗和运动活性，这表明与假手术相比，VSG 大鼠显著降低了 4 周内的累计能量摄入，从而导致体重减轻。LCHF 喂养的假手术大鼠摄入的能量最多，其次是 HF 喂养的大鼠。相比之下，在 VSG 后，HF-VSG 组大鼠的累计能量摄入最高，但与 CH 和 LCHF 组无差异。同样，HF 饮食组大鼠在 VSG 手术后 BW 和脂肪量的反弹最高。VSG 改善了血脂谱，但饮食对其没有差异影响。
总之，HF 饮食的摄入而非能量更密集的 LCHF 饮食降低了 VSG 在大鼠中的有效性。
