Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
Surg Today. 2019 Jul;49(7):637-644. doi: 10.1007/s00595-019-1772-x. Epub 2019 Jan 31.
Sleeve gastrectomy with duodenojejunal bypass (SG-DJB) is expected to become a popular procedure in East Asia. The aim of this study was to evaluate the effects of duodenojejunal bypass on glucose metabolism in a rat model of sleeve gastrectomy (SG).
Twenty-four Sprague-Dawley rats were divided into two groups: SG-DJB and SG alone. 6 weeks after surgery, body weight, feed intake, and metabolic parameters were measured, and oral glucose tolerance tests (OGTT) were performed. The mRNA expression of factors related to gluconeogenesis and glucose transport was evaluated using jejunal samples. Protein expression of factors with significantly different mRNA expression levels was evaluated using immunohistochemistry.
Body weight and metabolic parameters did not significantly differ between the two groups. During the OGTT, the SG-DJB group showed an early increase in serum insulin followed by an early decrease in blood glucose compared with the SG group. Expression levels of glucose transporter 1 (GLUT1) and sodium-glucose cotransporter 1 (SGLT1) mRNA and protein in the alimentary limb (AL) were greater in the SG-DJB group than in the SG group.
The additional effects of duodenojejunal bypass on glucose metabolism after SG may be related to increased expression of GLUT1 and SGLT1 in the AL.
袖状胃切除术联合空肠-回肠旁路术（SG-DJB）有望在东亚成为一种流行的手术。本研究旨在评估空肠-回肠旁路术对袖状胃切除术（SG）大鼠模型葡萄糖代谢的影响。
将 24 只 Sprague-Dawley 大鼠随机分为 SG-DJB 组和 SG 组。术后 6 周，测量体重、摄食量和代谢参数，并进行口服葡萄糖耐量试验（OGTT）。使用空肠样本评估与糖异生和葡萄糖转运相关的因子的 mRNA 表达。使用免疫组织化学评估具有显著不同 mRNA 表达水平的因子的蛋白表达。
两组间体重和代谢参数无显著差异。在 OGTT 期间，与 SG 组相比，SG-DJB 组的血清胰岛素早期增加，随后血糖早期下降。SG-DJB 组的肠段（AL）葡萄糖转运蛋白 1（GLUT1）和钠-葡萄糖协同转运蛋白 1（SGLT1）mRNA 和蛋白表达水平高于 SG 组。
SG 后空肠-回肠旁路术对葡萄糖代谢的额外影响可能与 AL 中 GLUT1 和 SGLT1 的表达增加有关。
