Melone Sirio, Fernandez-Cebrian Jose Maria, Amores Mario, Lopez-Tofiño Yolanda, Perez-Fernandez Elia, Garcia-Garcia Elena, Acedo Juan Manuel, Guijarro Carlos, Cortijo Sagrario Martinez, Abalo Raquel, Pazos Maria Ruth
Universidad Rey Juan Carlos, Alcorcón, Spain.
Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Obes Surg. 2025 May;35(5):1620-1629. doi: 10.1007/s11695-025-07799-4. Epub 2025 Mar 25.
The incidence of type 2 diabetes mellitus (T2DM) is raising with significant associated medical complications and mortality. Bariatric surgery has shown to have beneficial metabolic effects. A model of single anastomosis duodenojejunal bypass with sleeve gastrectomy (SADJB-SG) was developed in a T2DM animal model without obesity, Goto-Kakizaki (GK) rats, to evaluate the effect of the procedure on glucose homeostasis.
Fourteen 12-week old GK rats underwent SADJB-SG, while 11 underwent simulated surgery (Sham). Weight and food intake were recorded comprehensively until sacrifice. Fasting blood glucose data, as well as insulin, fructosamine, and albumin levels were measured both pre-surgically and just before sacrifice. Glucose homeostasis was also monitored by oral glucose tolerance test (OGTT) at different time points. A radiographic study was performed to assess the effect of surgery on gastric emptying.
Mortality rate was 24% in the SADJB-SG and 4% in Sham rats. Despite similar food intake, the SADJB-SG showed significant weight loss coupled to a decrease in albumin levels. Glucose homeostasis improved in SADJB-SG rats after surgery, reflected in decreased blood glucose, fructosamine levels, and homeostasis model assessment of insulin resistance index (HOMA-IR). OGTT tests, conducted both post-surgery and at follow-up, demonstrated an improvement in glucose metabolism 120 min after glucose administration. However, a peak in glycemia was observed at 30 min, which negatively affected the expected AUC results. Gastric emptying was accelerated in the SADJB-SG, which could contribute to explain the observed glycemia increment, through fast glucose jejunal uptake.
SADJB-SG surgery improved glucose homeostasis in GK rats.
2型糖尿病（T2DM）的发病率正在上升，伴有严重的相关医学并发症和死亡率。减肥手术已显示出有益的代谢作用。在无肥胖的T2DM动物模型——Goto-Kakizaki（GK）大鼠中开发了一种单吻合十二指肠空肠旁路联合袖状胃切除术（SADJB-SG）模型，以评估该手术对葡萄糖稳态的影响。
14只12周龄的GK大鼠接受了SADJB-SG手术，而11只接受了模拟手术（假手术）。在处死前全面记录体重和食物摄入量。在手术前和处死前测量空腹血糖数据以及胰岛素、果糖胺和白蛋白水平。还在不同时间点通过口服葡萄糖耐量试验（OGTT）监测葡萄糖稳态。进行影像学研究以评估手术对胃排空的影响。
SADJB-SG组的死亡率为24%，假手术组为4%。尽管食物摄入量相似，但SADJB-SG组体重显著减轻，同时白蛋白水平降低。SADJB-SG组大鼠术后葡萄糖稳态得到改善，表现为血糖、果糖胺水平降低以及胰岛素抵抗指数的稳态模型评估（HOMA-IR）降低。术后和随访时进行的OGTT试验表明，葡萄糖给药后120分钟葡萄糖代谢有所改善。然而，在30分钟时观察到血糖峰值，这对预期的AUC结果产生了负面影响。SADJB-SG组胃排空加速，这可能有助于解释观察到的血糖升高，这是由于葡萄糖在空肠快速吸收所致。
SADJB-SG手术改善了GK大鼠的葡萄糖稳态。
