ABSTRACT
OBJECTIVE: To evaluate the effects of jejunal-ileal bypass(JIB) in addition to sleeve gastrectomy(SG) on glycemic regulation and body weight in Zucker Diabetic Fatty(ZDF) rats and underlying mechnisms. METHODS: Twelve ZDF(fa/fa) rats were randomly divided into two groups based upon the procedure performed including sleeve gastrectomy plus jejunal-ileal bypass surgery group(SG+JIB,n=6) and sleeve gastrectomy plus sham procedure group(SG+Sham,n=6). In addition,five healthy ZDF(fa/+) rats were employed as normal controls. Body weight,fasting blood glucose,food intake,oral glucose tolerance test and plasma GLP-1 levels were measured before surgery and at 2 and 4 weeks after surgery. RESULTS: Preoperatively,all baseline parametes had no statistical difference between SG+JIB and SG+Sham groups. In comparison with SG+Sham group,fasting plasma glucose levels at postoperative week 2(17.3 mmol/L vs. 8.7 mmol/L) and 4(21.4 mmol/L vs. 11.9 mmol/L)were significantly lower in SG + JIB group(P<0.0001). Oral glucose tolerace was significantly improved,represented by glucose excursion area under curve for 180 minutes period(4221 vs.2964,P<0.0001 at postoperative week 2;and 4104 vs. 3388,P<0.01 at postoperative week 4). Simutaneously,plasma GLP-1 levels were significantly higher in SG + JIB group than SG + Sham group(64.58 pmol/L v.s.30.52 pmol/L,P<0.001). However,SG + JIB had less food intake and body weight only decreased at postoperative week 2,but not at week 4. CONCLUSION: By adding JIB onto SG,the metabolic regulation capability is able to be furtherly enhanced. However,it seems that there is not additional benefit in weight loss.Therefore,based upon these results,we suggest that SG + JIB should be recommended to the patients who needs additional metabolic effects,but not to the patients for the purpose of additional weight loss above SG alone.
ABSTRACT
Objective To investigate the expression of hormone sensitive lipase (HSL) and carnitine acyl transferase-1 (CAT-1) in Zucker rats after sleeve gastrectomy and to discuss the weight loss mechanism.Methods 30 male Zucker rats aging 10 weeks were randomly divided into 3 groups:the operation group (10 rats),the sham operation group (10 rats) and the diet-pairing group (10 rats).The rats were decapitated to retrieve the retroperitoneal adipose,mRNA and protein expression of HSL and CAT-1 gene of were detected by RTPCR and Western blot.Results As for the operation group,the weight decreased significantly after the operation comparing to the other two groups ((250±5.8) g,(370±10.0) g,(310±9.6) g,P＜0.05).mRNA and protein expressions of HSL and CAT-1 gene were all significantly higher in the operation group (P＜0.05).Conclusion SG can up-regulate the expressions of lipolysis gene HSL and CAT-1 in adipose in Zucker rats,promoting fat hydrolysis and increasing the energy expenditure,which is one of the important mechanisms of weight loss.