Department of Surgery, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Department of Internal Medicine I, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Int J Surg. 2020 Mar;75:139-147. doi: 10.1016/j.ijsu.2020.01.139. Epub 2020 Feb 1.
Sleeve gastrectomy (SG) is an effective procedure to treat morbid obesity. SG induces remission of type 2 diabetes and metabolic syndrome and improves non-alcoholic fatty liver disease (NAFLD). However, it is imperative to clarify the extent to which these beneficial effects may be attributed to SG among other concomitant changes including postoperative diet. The current study addresses this question in a rodent model of obesity by subjecting it to SG, normal diet, or a combination of the two.
Male Wistar-rats were fed with either high fat diet (HF, n = 32) or received chow diet (CD, n = 8). After 15 weeks, the HF-fed rats underwent either SG or sham operation, following which they were randomised to either continue HF or switched to CD for another 6 weeks. Body weight, fasting blood glucose level, blood pressure, and adipokine expression (leptin, adiponectin, MCP-1) in the adipose tissue along with triglycerides level in the blood serum were assessed to evaluate metabolic function. Hepatic function was assessed by histological evaluation of liver fibrosis (Hydroxyproline, Sirius Red) and reverse transcription polymerase chain reaction (RT-PCR) of the inflammation marker monocyte chemoattractant protein-1 (MCP-1).
Postoperative dietary change improved adipose tissue inflammation and arterial blood pressure regardless of the surgical intervention, while SG improved hyperglycaemia, blood triglyceride levels and, regardless of the postoperative diet, hepatic inflammation and fibrosis. However, combined administration of SG with post-operative normal diet was the most effective with regard to reducing the body weight.
HF for 15 weeks induced obesity with metabolic syndrome and NAFLD in rats. SG and dietary intervention improved metabolic state and NAFLD; however, their combination was significantly more effective.
袖状胃切除术（SG）是治疗病态肥胖的有效方法。SG 可诱导 2 型糖尿病和代谢综合征的缓解，并改善非酒精性脂肪性肝病（NAFLD）。然而，必须明确这些有益效果在多大程度上可以归因于 SG，以及其他伴随的变化，包括术后饮食。本研究通过在肥胖的啮齿动物模型中进行 SG、正常饮食或两者的组合来解决这个问题。
雄性 Wistar 大鼠分别给予高脂肪饮食（HF，n=32）或标准饮食（CD，n=8）。15 周后，HF 喂养的大鼠接受 SG 或假手术，然后随机分为继续 HF 或切换为 CD 再 6 周。评估体重、空腹血糖水平、血压和脂肪组织中脂肪因子（瘦素、脂联素、MCP-1）的表达以及血清中甘油三酯水平，以评估代谢功能。通过羟脯氨酸、天狼星红评估肝纤维化的组织学评估和炎症标志物单核细胞趋化蛋白-1（MCP-1）的逆转录聚合酶链反应（RT-PCR）评估肝功能。
术后饮食改变改善了脂肪组织炎症和动脉血压，无论手术干预如何，而 SG 改善了高血糖、血甘油三酯水平，并且无论术后饮食如何，还改善了肝炎症和纤维化。然而，SG 联合术后正常饮食在降低体重方面最为有效。
15 周 HF 诱导肥胖大鼠出现代谢综合征和 NAFLD。SG 和饮食干预改善了代谢状态和 NAFLD；然而，两者的结合效果更为显著。
