Department of General Surgery, Qilu Hospital of Shandong University, #107 Wenhua Xi Road, Jinan, 250012, Shandong, People's Republic of China.
Obes Surg. 2012 Dec;22(12):1865-73. doi: 10.1007/s11695-012-0744-7.
As a new bariatric procedure, sleeve gastrectomy with duodenal-jejunal bypass (SGDJB) needs further assessment. We compared the diabetic control between SGDJB and sleeve gastrectomy (SG) in Goto-Kakizaki (GK) rats, a nonobese rat model of type 2 diabetes. Our aim is firstly to develop a nonobese diabetic rat model for SGDJB and secondly to investigate the feasibility and safety of SGDJB to induce diabetes remission.
Fifty 11-week-old male GK rats were divided into five groups: sham-operated SG (SOSG), sham-operated SGDJB (SOSGDJB), control, SG, and SGDJB. Rats were observed for 16 weeks after surgery. The body weight, food intake, glycemic control outcomes, ghrelin, peptide YY (PYY), insulin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic peptide were measured.
The operated groups showed lower food intake since 4 weeks postoperation and significant weight loss since 6 weeks postoperation. SGDJB and SG surgeries induced a decreased fasting ghrelin level and increased levels of glucose-stimulated insulin, GLP-1, and PYY secretion at 2 and 16 weeks postoperation. Compared with the SG group, the SGDJB group showed higher glucose-stimulated GLP-1 levels. Both SGDJB and SG groups exhibited significant improvement in oral glucose tolerance and insulin tolerance compared with sham-operated and control groups, but there was no difference between the operated groups.
This nonobese diabetic rat model may be valuable in studying the effect of SGDJB on diabetic control. SGDJB shows similar improvement of glucose metabolism with SG. Our findings do not provide evidence for the foregut-mediated amelioration in glucose homeostasis.
作为一种新的减重手术，袖状胃旁路术联合十二指肠空肠旁路术（SGDJB）需要进一步评估。我们比较了 Goto-Kakizaki（GK）大鼠（2 型糖尿病的非肥胖模型）中 SGDJB 和袖状胃切除术（SG）之间的糖尿病控制情况。我们的目的首先是开发一种用于 SGDJB 的非肥胖糖尿病大鼠模型，其次是研究 SGDJB 诱导糖尿病缓解的可行性和安全性。
将 50 只 11 周龄雄性 GK 大鼠分为五组：假手术 SG（SOSG）、假手术 SGDJB（SOSGDJB）、对照组、SG 和 SGDJB。手术后观察大鼠 16 周。测量体重、食物摄入量、血糖控制结果、胃饥饿素、肽 YY（PYY）、胰岛素、胰高血糖素样肽 1（GLP-1）和葡萄糖依赖性胰岛素释放肽。
手术后的各组大鼠从术后 4 周开始表现出较低的食物摄入量，术后 6 周开始出现显著的体重减轻。SGDJB 和 SG 手术可降低空腹胃饥饿素水平，并在术后 2 和 16 周增加葡萄糖刺激的胰岛素、GLP-1 和 PYY 分泌。与 SG 组相比，SGDJB 组表现出更高的葡萄糖刺激 GLP-1 水平。与假手术和对照组相比，SGDJB 和 SG 组的口服葡萄糖耐量和胰岛素耐量均有显著改善，但两组之间无差异。
这种非肥胖糖尿病大鼠模型可能对研究 SGDJB 对糖尿病控制的影响有价值。SGDJB 显示出与 SG 相似的改善葡萄糖代谢作用。我们的研究结果没有提供前肠介导改善葡萄糖稳态的证据。
