Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan.
Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.
Obes Surg. 2024 May;34(5):1665-1673. doi: 10.1007/s11695-024-07176-7. Epub 2024 Mar 21.
Duodenal-jejunal bypass (DJB) is an experimental procedure in metabolic surgery that does not have a restrictive component. Changes in bile acid (BA) dynamics and intestinal microbiota are possibly related to metabolic improvement after DJB. Our previous studies involving obese diabetic rats showed the crucial role of the biliopancreatic limb (BPL) in metabolic improvement after DJB caused by BA reabsorption. We established a new DJB procedure to prevent bile from flowing into the BPL and aimed to elucidate the importance of bile in the BPL after DJB.
Otsuka Long-Evans Tokushima Fatty rats with diabetes were divided into three groups: two DJB groups and a sham group (n = 11). Duodenal-jejunal anastomosis was performed proximal to the papilla of Vater in the DJB group (n = 11). However, the DJB-D group (n = 11) underwent a new procedure with duodenal-jejunal anastomosis distal to the papilla of Vater for preventing bile flow into the BPL.
Glucose metabolism improved and weight gain was suppressed in the DJB group, but not in the DJB-D and sham groups. Serum BA level and conjugated BA concentration were elevated in the DJB group. The gut microbiota was altered only in the DJB group; the abundance of Firmicutes and Bacteroidetes decreased and that of Actinobacteria increased. However, the DJB-D group exhibited no apparent change in the gut microbiota, similar to the sham group.
BAs are essential in the BPL for metabolic improvement after DJB; they can improve the gut microbiota in these processes.
十二指肠空肠旁路术（DJB）是代谢手术中的一种实验性程序，它没有限制成分。胆汁酸（BA）动力学和肠道微生物群的变化可能与 DJB 后代谢改善有关。我们之前的研究涉及肥胖糖尿病大鼠，表明在 DJB 后，由于 BA 重吸收，BPL 在代谢改善中起着关键作用。我们建立了一种新的 DJB 程序，以防止胆汁流入 BPL，并旨在阐明 BPL 中胆汁的重要性。
糖尿病的 Otsuka Long-Evans Tokushima Fatty 大鼠分为三组：两组 DJB 组和一组假手术组（n=11）。在 DJB 组进行十二指肠空肠吻合术，位于 Vater 乳头的近端（n=11）。然而，DJB-D 组（n=11）进行了新的手术，即在 Vater 乳头的远端进行十二指肠空肠吻合术，以防止胆汁流入 BPL。
DJB 组的葡萄糖代谢改善，体重增加受到抑制，但 DJB-D 组和假手术组没有。血清 BA 水平和结合 BA 浓度在 DJB 组升高。仅 DJB 组的肠道微生物群发生改变；厚壁菌门和拟杆菌门的丰度减少，放线菌门的丰度增加。然而，DJB-D 组的肠道微生物群没有明显变化，与假手术组相似。
BA 是 DJB 后代谢改善中 BPL 的必需物质；它们可以改善这些过程中的肠道微生物群。
