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Erschienen in: Obesity Surgery 5/2021

28.01.2021 | Original Contributions

Comparing the Anti-diabetic Effect of Sleeve Gastrectomy with Transit Bipartition Against Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Using a Diabetic Rodent Model

verfasst von: Pengpeng Liu, Jason Widjaja, Ponnie Robertlee Dolo, Libin Yao, Jian Hong, Yong Shao, Xiaocheng Zhu

Erschienen in: Obesity Surgery | Ausgabe 5/2021

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Abstract

Purpose

Roux-en-Y gastric bypass (RYGB) has superior long-term diabetes remission outcomes to sleeve gastrectomy (SG). However, in regions with a high prevalence of gastric cancer, RYGB may not be the best option. This study aimed to investigate the anti-diabetic effect of SG with transit bipartition (SG-TB) compared with SG and RYGB.

Materials and Methods

A total of 32 diabetic Sprague-Dawley rat models were assigned to one of four groups: SG (n = 8), RYGB (n = 8), SG-TB (n = 8), and SHAM (n = 8). Body weight, food intake, blood glucose, and hormonal changes (glucagon-like peptide-1 (GLP-1), insulin, and glucagon) were measured to investigate the effect of surgery in all groups. Oral glucose tolerance test and insulin tolerance test were performed before and 8 weeks after surgery.

Results

There were no significant differences in the postoperative changes in body weight and food intake among the SG, RYGB, and SG-TB groups. Postoperatively, the RYGB and SG-TB groups had significantly higher GLP-1 levels and lower insulin levels than the SG group. Further, RYGB and SG-TB had significantly better glucose control improvements than SG. There were no significant differences in GLP-1, insulin, glucagon, and homeostasis model assessment of insulin resistance levels between RYGB and SG-TB. The preoperative and postoperative values of all variables in the SHAM group did not show significant differences.

Conclusion

In this study using a diabetes-induced rodent model, we found that the anti-diabetic effect of SG-TB is superior to that of SG and non-inferior to that of RYGB.
Literatur
1.
Zurück zum Zitat Wu J, Xu H, He X, et al. Six-year changes in the prevalence of obesity and obesity-related diseases in Northeastern China from 2007 to 2013. Sci Rep. 2017;7:41518.PubMedPubMedCentralCrossRef Wu J, Xu H, He X, et al. Six-year changes in the prevalence of obesity and obesity-related diseases in Northeastern China from 2007 to 2013. Sci Rep. 2017;7:41518.PubMedPubMedCentralCrossRef
2.
Zurück zum Zitat Zhang L, Wang Z, Wang X, et al. Prevalence of abdominal obesity in China: results from a cross-sectional study of nearly half a million participants. Obesity (Silver Spring). 2019;27(11):1898–905.CrossRef Zhang L, Wang Z, Wang X, et al. Prevalence of abdominal obesity in China: results from a cross-sectional study of nearly half a million participants. Obesity (Silver Spring). 2019;27(11):1898–905.CrossRef
3.
Zurück zum Zitat Ma RCW. Epidemiology of diabetes and diabetic complications in China. Diabetologia. 2018;61(6):1249–60.PubMedCrossRef Ma RCW. Epidemiology of diabetes and diabetic complications in China. Diabetologia. 2018;61(6):1249–60.PubMedCrossRef
4.
Zurück zum Zitat Du X, Dai R, Zhou HX, et al. Bariatric surgery in china: how is this new concept going? Obes Surg. 2016;26(12):2906–12.PubMedCrossRef Du X, Dai R, Zhou HX, et al. Bariatric surgery in china: how is this new concept going? Obes Surg. 2016;26(12):2906–12.PubMedCrossRef
5.
Zurück zum Zitat Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29(3):782–95.PubMedCrossRef Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29(3):782–95.PubMedCrossRef
6.
Zurück zum Zitat Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376(7):641–51.PubMedPubMedCentralCrossRef Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376(7):641–51.PubMedPubMedCentralCrossRef
7.
Zurück zum Zitat Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA. 2018;319(3):241–54.PubMedPubMedCentralCrossRef Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA. 2018;319(3):241–54.PubMedPubMedCentralCrossRef
8.
Zurück zum Zitat Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65.PubMedPubMedCentralCrossRef Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65.PubMedPubMedCentralCrossRef
9.
Zurück zum Zitat Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.PubMedCrossRef Shoar S, Saber AA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.PubMedCrossRef
10.
Zurück zum Zitat Golzarand M, Toolabi K, Farid R. The bariatric surgery and weight losing: a meta-analysis in the long- and very long-term effects of laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy on weight loss in adults. Surg Endosc. 2017;31(11):4331–45.PubMedCrossRef Golzarand M, Toolabi K, Farid R. The bariatric surgery and weight losing: a meta-analysis in the long- and very long-term effects of laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy on weight loss in adults. Surg Endosc. 2017;31(11):4331–45.PubMedCrossRef
11.
Zurück zum Zitat Yang P, Chen B, Xiang S, et al. Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: results from a meta-analysis of randomized controlled trials. Surg Obes Relat Dis. 2019;15(4):546–55.PubMedCrossRef Yang P, Chen B, Xiang S, et al. Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: results from a meta-analysis of randomized controlled trials. Surg Obes Relat Dis. 2019;15(4):546–55.PubMedCrossRef
12.
13.
Zurück zum Zitat Lyons K, Le LC, Pham YT, et al. Gastric cancer: epidemiology, biology, and prevention: a mini review. Eur J Cancer Prev. 2019;28(5):397–412.PubMedCrossRef Lyons K, Le LC, Pham YT, et al. Gastric cancer: epidemiology, biology, and prevention: a mini review. Eur J Cancer Prev. 2019;28(5):397–412.PubMedCrossRef
14.
Zurück zum Zitat Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10.PubMedCrossRef Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10.PubMedCrossRef
15.
Zurück zum Zitat Yormaz S, Yılmaz H, Ece I, et al. Laparoscopic ileal interposition with diverted sleeve gastrectomy versus laparoscopic transit bipartition with sleeve gastrectomy for better glycemic outcomes in T2DM patients. Obes Surg. 2018;28(1):77–86.PubMedCrossRef Yormaz S, Yılmaz H, Ece I, et al. Laparoscopic ileal interposition with diverted sleeve gastrectomy versus laparoscopic transit bipartition with sleeve gastrectomy for better glycemic outcomes in T2DM patients. Obes Surg. 2018;28(1):77–86.PubMedCrossRef
16.
Zurück zum Zitat Azevedo FR, Santoro S, Correa-Giannella ML, et al. A prospective randomized controlled trial of the metabolic effects of sleeve gastrectomy with transit bipartition. Obes Surg. 2018;28(10):3012–9.PubMedCrossRef Azevedo FR, Santoro S, Correa-Giannella ML, et al. A prospective randomized controlled trial of the metabolic effects of sleeve gastrectomy with transit bipartition. Obes Surg. 2018;28(10):3012–9.PubMedCrossRef
17.
Zurück zum Zitat Bilecik T. Metabolic effects of sleeve gastrectomy with transit bipartition in obese females with type 2 diabetes mellitus: results after 1-year follow-up. Obes Surg. 2019;29(3):805–10.PubMedCrossRef Bilecik T. Metabolic effects of sleeve gastrectomy with transit bipartition in obese females with type 2 diabetes mellitus: results after 1-year follow-up. Obes Surg. 2019;29(3):805–10.PubMedCrossRef
18.
Zurück zum Zitat Topart P, Becouarn G, Finel JB. Is transit bipartition a better alternative to biliopancreatic diversion with duodenal switch for superobesity? Comparison of the early results of both procedures. Surg Obes Relat Dis. 2020;16(4):497–502.PubMedCrossRef Topart P, Becouarn G, Finel JB. Is transit bipartition a better alternative to biliopancreatic diversion with duodenal switch for superobesity? Comparison of the early results of both procedures. Surg Obes Relat Dis. 2020;16(4):497–502.PubMedCrossRef
19.
Zurück zum Zitat Karaca FC. Effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes, and nutritional status in type 2 diabetes mellitus patients. Obes Surg. 2020;30(4):1437–45.PubMedCrossRef Karaca FC. Effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes, and nutritional status in type 2 diabetes mellitus patients. Obes Surg. 2020;30(4):1437–45.PubMedCrossRef
20.
Zurück zum Zitat Topart P, Becouarn G, Finel JB. Comparison of 2-year results of Roux-en-Y gastric bypass and transit bipartition with sleeve gastrectomy for superobesity. Obes Surg. 2020;30(9):3402–7.PubMedCrossRef Topart P, Becouarn G, Finel JB. Comparison of 2-year results of Roux-en-Y gastric bypass and transit bipartition with sleeve gastrectomy for superobesity. Obes Surg. 2020;30(9):3402–7.PubMedCrossRef
21.
Zurück zum Zitat Widjaja J, Dolo PR, Zhang Q, et al. Bypassed and preserved stomach resulted in superior glucose control in Sprague-Dawley rats with streptozotocin-induced diabetes. Sci Rep. 2019;9(1):9981.PubMedPubMedCentralCrossRef Widjaja J, Dolo PR, Zhang Q, et al. Bypassed and preserved stomach resulted in superior glucose control in Sprague-Dawley rats with streptozotocin-induced diabetes. Sci Rep. 2019;9(1):9981.PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat Dolo PR, Yao L, Li C, et al. Preserving duodenal-jejunal (foregut) transit does not impair glucose tolerance and diabetes remission following gastric bypass in type 2 diabetes Sprague-Dawley rat model. Obes Surg. 2018;28(5):1313–20.PubMedCrossRef Dolo PR, Yao L, Li C, et al. Preserving duodenal-jejunal (foregut) transit does not impair glucose tolerance and diabetes remission following gastric bypass in type 2 diabetes Sprague-Dawley rat model. Obes Surg. 2018;28(5):1313–20.PubMedCrossRef
23.
Zurück zum Zitat Meier JJ. GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2012;8(12):728–42.PubMedCrossRef Meier JJ. GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2012;8(12):728–42.PubMedCrossRef
25.
Zurück zum Zitat Smith EP, Polanco G, Yaqub A, et al. Altered glucose metabolism after bariatric surgery: what’s GLP-1 got to do with it? Metabolism. 2018;83:159–66. Smith EP, Polanco G, Yaqub A, et al. Altered glucose metabolism after bariatric surgery: what’s GLP-1 got to do with it? Metabolism. 2018;83:159–66.
26.
Zurück zum Zitat Egerod KL, Engelstoft MS, Grunddal KV, et al. A major lineage of enteroendocrine cells coexpress CCK, secretin, GIP, GLP-1, PYY, and neurotensin but not somatostatin. Endocrinology. 2012;153(12):5782–95.PubMedPubMedCentralCrossRef Egerod KL, Engelstoft MS, Grunddal KV, et al. A major lineage of enteroendocrine cells coexpress CCK, secretin, GIP, GLP-1, PYY, and neurotensin but not somatostatin. Endocrinology. 2012;153(12):5782–95.PubMedPubMedCentralCrossRef
27.
Zurück zum Zitat Chambers AP, Jessen L, Ryan KK, et al. Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology. 2011;141(3):950–8.PubMedPubMedCentralCrossRef Chambers AP, Jessen L, Ryan KK, et al. Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology. 2011;141(3):950–8.PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Nosso G, Griffo E, Cotugno M, et al. Comparative effects of Roux-en-Y gastric bypass and sleeve gastrectomy on glucose homeostasis and incretin hormones in obese type 2 diabetic patients: a one-year prospective study. Horm Metab Res. 2016;48(5):312–7.PubMedCrossRef Nosso G, Griffo E, Cotugno M, et al. Comparative effects of Roux-en-Y gastric bypass and sleeve gastrectomy on glucose homeostasis and incretin hormones in obese type 2 diabetic patients: a one-year prospective study. Horm Metab Res. 2016;48(5):312–7.PubMedCrossRef
29.
Zurück zum Zitat Castagneto Gissey L, Casella Mariolo J, Mingrone G. Intestinal peptide changes after bariatric and minimally invasive surgery: relation to diabetes remission. Peptides. 2018 Feb;100:114–22.PubMedCrossRef Castagneto Gissey L, Casella Mariolo J, Mingrone G. Intestinal peptide changes after bariatric and minimally invasive surgery: relation to diabetes remission. Peptides. 2018 Feb;100:114–22.PubMedCrossRef
30.
Zurück zum Zitat Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17(1):57–62.PubMedCrossRef Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17(1):57–62.PubMedCrossRef
31.
Zurück zum Zitat Yin DP, Gao Q, Ma LL, et al. Assessment of different bariatric surgeries in the treatment of obesity and insulin resistance in mice. Ann Surg. 2011;254(1):73–82.PubMedPubMedCentralCrossRef Yin DP, Gao Q, Ma LL, et al. Assessment of different bariatric surgeries in the treatment of obesity and insulin resistance in mice. Ann Surg. 2011;254(1):73–82.PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Mingrone G, Cummings DE. Changes of insulin sensitivity and secretion after bariatric/metabolic surgery. Surg Obes Relat Dis. 2016;12(6):1199–205.PubMedCrossRef Mingrone G, Cummings DE. Changes of insulin sensitivity and secretion after bariatric/metabolic surgery. Surg Obes Relat Dis. 2016;12(6):1199–205.PubMedCrossRef
33.
Zurück zum Zitat Vrbikova J, Kunesova M, Kyrou I, et al. Insulin sensitivity and secretion in obese type 2 diabetic women after various bariatric operations. Obes Facts. 2016;9(6):410–23.PubMedPubMedCentralCrossRef Vrbikova J, Kunesova M, Kyrou I, et al. Insulin sensitivity and secretion in obese type 2 diabetic women after various bariatric operations. Obes Facts. 2016;9(6):410–23.PubMedPubMedCentralCrossRef
34.
Zurück zum Zitat Shi X, Chacko S, Li F, et al. Acute activation of GLP-1-expressing neurons promotes glucose homeostasis and insulin sensitivity. Mol Metab. 2017;6(11):1350–9.PubMedPubMedCentralCrossRef Shi X, Chacko S, Li F, et al. Acute activation of GLP-1-expressing neurons promotes glucose homeostasis and insulin sensitivity. Mol Metab. 2017;6(11):1350–9.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Rebelos E, Astiarraga B, Bizzotto R, et al. GLP-1 response to sequential mixed meals: influence of insulin resistance. Clin Sci (Lond). 2017;131(24):2901–10.CrossRef Rebelos E, Astiarraga B, Bizzotto R, et al. GLP-1 response to sequential mixed meals: influence of insulin resistance. Clin Sci (Lond). 2017;131(24):2901–10.CrossRef
36.
Zurück zum Zitat Yaribeygi H, Sathyapalan T, Sahebkar A. Molecular mechanisms by which GLP-1 RA and DPP-4i induce insulin sensitivity. Life Sci. 2019;234:116776.PubMedCrossRef Yaribeygi H, Sathyapalan T, Sahebkar A. Molecular mechanisms by which GLP-1 RA and DPP-4i induce insulin sensitivity. Life Sci. 2019;234:116776.PubMedCrossRef
38.
Zurück zum Zitat Kulina GR, Rayfield EJ. The role of glucagon in the pathophysiology and management of diabetes. Endocr Pract. 2016;22(5):612–21.PubMedCrossRef Kulina GR, Rayfield EJ. The role of glucagon in the pathophysiology and management of diabetes. Endocr Pract. 2016;22(5):612–21.PubMedCrossRef
39.
Zurück zum Zitat Lee YH, Wang MY, Yu XX, et al. Glucagon is the key factor in the development of diabetes. Diabetologia. 2016;59(7):1372–5.PubMedCrossRef Lee YH, Wang MY, Yu XX, et al. Glucagon is the key factor in the development of diabetes. Diabetologia. 2016;59(7):1372–5.PubMedCrossRef
40.
Zurück zum Zitat Hædersdal S, Lund A, Knop FK, et al. The role of glucagon in the pathophysiology and treatment of type 2 diabetes. Mayo Clin Proc. 2018;93(2):217–39.PubMedCrossRef Hædersdal S, Lund A, Knop FK, et al. The role of glucagon in the pathophysiology and treatment of type 2 diabetes. Mayo Clin Proc. 2018;93(2):217–39.PubMedCrossRef
41.
Zurück zum Zitat Duca FA, Côté CD, Rasmussen BA, et al. Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats. Nat Med. 2015;21(5):506–11.PubMedPubMedCentralCrossRef Duca FA, Côté CD, Rasmussen BA, et al. Metformin activates a duodenal Ampk-dependent pathway to lower hepatic glucose production in rats. Nat Med. 2015;21(5):506–11.PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Murphy R, Clarke MG, Evennett NJ, et al. Laparoscopic sleeve gastrectomy versus banded Roux-en-Y gastric bypass for diabetes and obesity: a prospective randomized double-blind trial. Obes Surg. 2018;28(2):293–302.PubMedCrossRef Murphy R, Clarke MG, Evennett NJ, et al. Laparoscopic sleeve gastrectomy versus banded Roux-en-Y gastric bypass for diabetes and obesity: a prospective randomized double-blind trial. Obes Surg. 2018;28(2):293–302.PubMedCrossRef
43.
Zurück zum Zitat Widjaja J, Pan H, Dolo PR, et al. Short-term diabetes remission outcomes in patients with BMI ≤ 30 kg/m2 following sleeve gastrectomy. Obes Surg. 2020;30(1):18–22.PubMedCrossRef Widjaja J, Pan H, Dolo PR, et al. Short-term diabetes remission outcomes in patients with BMI ≤ 30 kg/m2 following sleeve gastrectomy. Obes Surg. 2020;30(1):18–22.PubMedCrossRef
44.
Zurück zum Zitat Aminian A, Brethauer SA, Andalib A, et al. Can sleeve gastrectomy “cure” diabetes? Long-term metabolic effects of sleeve gastrectomy in patients with type 2 diabetes. Ann Surg. 2016;264(4):674–81.PubMedCrossRef Aminian A, Brethauer SA, Andalib A, et al. Can sleeve gastrectomy “cure” diabetes? Long-term metabolic effects of sleeve gastrectomy in patients with type 2 diabetes. Ann Surg. 2016;264(4):674–81.PubMedCrossRef
45.
Zurück zum Zitat Lee MH, Almalki OM, Lee WJ, et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: long-term result and recurrence of diabetes. Obes Surg. 2020;30(10):3669–74.PubMedCrossRef Lee MH, Almalki OM, Lee WJ, et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: long-term result and recurrence of diabetes. Obes Surg. 2020;30(10):3669–74.PubMedCrossRef
46.
Zurück zum Zitat Lee WJ, Almuhanna M. Paired editorial: effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes and nutritional status in type 2 diabetes mellitus patients: a 1-year follow-up study. Obes Surg. 2020;30(3):1128–9.PubMedCrossRef Lee WJ, Almuhanna M. Paired editorial: effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes and nutritional status in type 2 diabetes mellitus patients: a 1-year follow-up study. Obes Surg. 2020;30(3):1128–9.PubMedCrossRef
Metadaten
Titel
Comparing the Anti-diabetic Effect of Sleeve Gastrectomy with Transit Bipartition Against Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Using a Diabetic Rodent Model
verfasst von
Pengpeng Liu
Jason Widjaja
Ponnie Robertlee Dolo
Libin Yao
Jian Hong
Yong Shao
Xiaocheng Zhu
Publikationsdatum
28.01.2021
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 5/2021
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05256-6

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