Ribeiro-Parenti Lara, El Jindi Hounayda, Willemetz Alexandra, Siebert Matthieu, Kapel Nathalie, Le Beyec Johanne, Bado André, Le Gall Maude
UMR-S 1149 Centre de Recherche sur l'Inflammation, Université Paris Cité, Inserm, 75018 Paris, France.
Service de Chirurgie Digestive œsogastrique et Bariatrique, Hôpital Bichat-Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, 75018 Paris, France.
J Clin Med. 2022 Aug 24;11(17):4976. doi: 10.3390/jcm11174976.
One anastomosis gastric bypass (OAGB) is associated with similar metabolic improvements and weight loss as Roux-en-Y gastric bypass (RYGB). However, this bariatric procedure is still controversial as it is suspected to result in undernutrition. Reducing the size of the biliopancreatic limb of OAGB could be essential to maintain positive outcomes while preventing side effects. The objective of this study was to compare and contrast outcomes of OAGB with two different biliopancreatic limb lengths to RYGB and Sham surgery in obese and non-obese rats. Lean and diet-induced obese Wistar rats were operated on RYGB, OAGB with a short (15 cm OAGB-15) or a long (35 cm OAGB-35) biliopancreatic limb or Sham surgery. Body weight and food intake were monitored over 30 weeks, and rats underwent oral glucose and insulin tolerance tests with a pancreatic and gut hormone secretion assay. Macronutrient absorption was determined by fecal analyses. Statistical analyses used non-parametric one-way or two-way ANOVA tests. Compared to Sham rats, RYGB, OAGB-15 and OAGB-35 rats displayed a significant reduced weight. Weight loss was greater after OAGB-35 than after OAGB-15 or Sham surgery because of transient malabsorption. All OAGB- and RYGB-operated rats displayed an improved pancreatic and gut hormone secretion in response to a meal compared to Sham rats, these effects were independent of limb length, rat weight, and maintained overtime. In conclusion, glucose homeostasis was similarly improved in obese and non-obese OAGB-15 and OAGB-35 rats suggesting that shortening the biliopancreatic limb can improve the metabolic parameters without a major influence on weight.
单吻合口胃旁路术（OAGB）与 Roux-en-Y 胃旁路术（RYGB）在代谢改善和体重减轻方面效果相似。然而，这种减肥手术仍存在争议，因为人们怀疑它会导致营养不良。缩短 OAGB 的胆胰支长度对于维持良好效果同时预防副作用可能至关重要。本研究的目的是比较和对比两种不同胆胰支长度的 OAGB 与 RYGB 及假手术在肥胖和非肥胖大鼠中的效果。将瘦素正常和饮食诱导肥胖的 Wistar 大鼠分别进行 RYGB、胆胰支短（15 cm OAGB - 15）或长（35 cm OAGB - 35）的 OAGB 手术或假手术。在 30 周内监测体重和食物摄入量，并对大鼠进行口服葡萄糖和胰岛素耐量试验以及胰腺和肠道激素分泌测定。通过粪便分析确定常量营养素吸收情况。统计分析采用非参数单因素或双因素方差分析测试。与假手术组大鼠相比，RYGB、OAGB - 15 和 OAGB - 35 组大鼠体重显著减轻。由于短暂性吸收不良，OAGB - 35 术后体重减轻幅度大于 OAGB - 15 或假手术组。与假手术组大鼠相比，所有接受 OAGB 和 RYGB 手术的大鼠进食后胰腺和肠道激素分泌均得到改善，这些作用与胆胰支长度、大鼠体重无关且长期维持。总之，肥胖和非肥胖的 OAGB - 15 和 OAGB - 35 大鼠的葡萄糖稳态同样得到改善，这表明缩短胆胰支长度可改善代谢参数，而对体重影响不大。
