Qi Xiaoyang, Li Xugang, Jiao Yuwen, Chen Shuai, Song Peng, Qian Zhifen, Tang Liming
Department of Gastrointestinal Surgery, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, People's Republic of China.
Department of Orthopaedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, People's Republic of China.
Diabetes Metab Syndr Obes. 2022 Feb 3;15:297-305. doi: 10.2147/DMSO.S351973. eCollection 2022.
Sleeve gastrectomy (SG) is the most currently popular operation for obesity and related metabolic disorders. The aim of this study was to compare the effect of antrum preservation SG (AP-SG) and antrum resection SG (AR-SG) on the body composition, glycemic control and bone mineral density (BMD) in mice.
Sham, AP-SG and AR-SG operation were performed on obese and T2D C57BL/6J mice (8 in each group). Body weight, food intake, and fasting glucose (FG) levels were measured at the 0, 2, 4, 6 and 8 weeks post-operatively. Oral glucose tolerance test (OGTT) was performed preoperatively and at the eighth postoperative week. The body fat content and total body BMD were evaluated by dual-energy x-ray absorptiometry. After being euthanized, the femurs were harvested and analyzed by micro-CT.
The improvements in body weight, food intake, FG, glycemic control and body fat were statistically significant following AP-SG and AR-SG. Both AP-SG and AR-SG groups decreased total body BMD and regional BMD in the distal femur compared to the sham group. No significant difference of FG was observed in AP-SG and AR-SG group postoperatively, but AR-SG showed significantly superior OGTT glucose AUC than AP-SG. Except for a lower BMD, AR-SG achieved superior outcomes in body fat and glycemic control than AP-SG.
Antrum resection SG shows a lower percentage of body fat and better glycemic control than antrum preservation SG. However, antrum resection SG has a higher risk of having a lower bone mass. Further human clinical trials are needed to confirm this finding.
袖状胃切除术(SG)是目前治疗肥胖症及相关代谢紊乱最常用的手术。本研究旨在比较保留胃窦袖状胃切除术(AP-SG)和切除胃窦袖状胃切除术(AR-SG)对小鼠身体成分、血糖控制和骨密度(BMD)的影响。
对肥胖且患有2型糖尿病的C57BL/6J小鼠(每组8只)进行假手术、AP-SG和AR-SG手术。在术后0、2、4、6和8周测量体重、食物摄入量和空腹血糖(FG)水平。术前及术后第8周进行口服葡萄糖耐量试验(OGTT)。通过双能X线吸收法评估体脂含量和全身骨密度。处死后,采集股骨并通过显微CT进行分析。
AP-SG和AR-SG术后体重、食物摄入量、FG、血糖控制和体脂的改善具有统计学意义。与假手术组相比,AP-SG和AR-SG组的全身骨密度和股骨远端局部骨密度均降低。AP-SG和AR-SG组术后FG无显著差异,但AR-SG的OGTT葡萄糖AUC显著优于AP-SG。除骨密度较低外,AR-SG在体脂和血糖控制方面的效果优于AP-SG。
与保留胃窦袖状胃切除术相比,切除胃窦袖状胃切除术的体脂百分比更低,血糖控制更好。然而,切除胃窦袖状胃切除术导致骨量降低的风险更高。需要进一步的人体临床试验来证实这一发现。