Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan.
Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York.
Am J Physiol Endocrinol Metab. 2021 Jul 1;321(1):E11-E23. doi: 10.1152/ajpendo.00060.2021. Epub 2021 May 17.
Nearly 80% of patients that receive bariatric surgery are women, yet mechanistic preclinical studies have focused on males. The goal of this study was to determine the metabolic impact of diet- and surgery-induced weight loss in males, females, and ovariectomized females. All mice were fed a 60% high-fat diet (HFD) before undergoing either vertical sleeve gastrectomy (VSG) or sham surgery. Mice either remained on an HFD or were switched to a standard chow diet postsurgically. When maintained on an HFD, males and females decreased fat mass and improved oral glucose tolerance after VSG. After dietary intervention, additional adiposity was lost in both surgical groups. Ovariectomized females showed a blunted decrease in fat mass on an HFD, but lost significant adiposity after dietary intervention. Energy expenditure was impacted by dietary and not surgical intervention across all groups. Males decreased hepatic triglyceride levels after VSG, which was further decreased after dietary intervention. Intact and ovariectomized females had a blunted decrease in hepatic triglycerides after VSG, but a significant decrease after dietary intervention. The more pronounced effect of VSG on hepatic lipids in males is strongly associated with changes in hepatic expression of genes and microRNAs previously linked to hepatic lipid regulation and systemic energy homeostasis. These data highlight the importance of postsurgical diet on metabolic outcomes across sexes. Furthermore, these data suggest the impact of VSG on hepatic triglycerides is diet-dependent in females and support the hypothesis that males and females achieve similar metabolic outcome, at least within the liver, via distinct mechanisms. These data highlight the interaction of postsurgical diet after bariatric surgery on metabolic outcomes across sexes. These data suggest the impact of VSG on hepatic triglycerides is diet-dependent in females and support the hypothesis that males and females achieve similar metabolic outcome, at least within the liver, via distinct mechanisms.
接受减肥手术的患者中近 80%为女性，但机械性临床前研究主要集中在男性。本研究的目的是确定饮食和手术引起的体重减轻对男性、女性和去卵巢女性的代谢影响。所有小鼠在接受垂直袖状胃切除术（VSG）或假手术前均喂食 60%高脂肪饮食（HFD）。手术后，小鼠要么继续喂食 HFD，要么切换为标准饲料。当维持在 HFD 时，男性和女性在 VSG 后均减少脂肪量并改善口服葡萄糖耐量。进行饮食干预后，两个手术组均进一步减轻了多余的脂肪量。去卵巢雌性在 HFD 上的脂肪量减少减少，但在饮食干预后显著减轻了脂肪量。能量消耗受到所有组的饮食而非手术干预的影响。雄性在 VSG 后肝甘油三酯水平降低，饮食干预后进一步降低。完整和去卵巢的雌性在 VSG 后肝甘油三酯降低减少，但饮食干预后显著降低。VSG 对雄性肝脂质的更明显影响与先前与肝脂质调节和全身能量稳态相关的肝基因和 microRNA 的表达变化强烈相关。这些数据强调了手术后饮食对跨性别代谢结果的重要性。此外，这些数据表明，VSG 对女性肝甘油三酯的影响取决于饮食，并且支持以下假设：男性和女性通过不同的机制至少在肝脏内达到相似的代谢结果。这些数据突出了减肥手术后手术后饮食对跨性别代谢结果的相互作用。这些数据表明，VSG 对女性肝甘油三酯的影响取决于饮食，并且支持以下假设：男性和女性通过不同的机制至少在肝脏内达到相似的代谢结果。
