Original articleGastric volume reduction is essential for the remission of type 2 diabetes mellitus after bariatric surgery in nonobese rats
Section snippets
Animals
The study protocol was reviewed and approved by the Institutional Animal Care and Utilization Committee of Fudan University Pudong Medical Center. A total of 30 male GK rats (a rat model of nonobese T2D)and 10 male Wistar (normal) rats, all aged 8 weeks, were purchased from Shanghai Slyke Laboratory Animal Corp. All animals were housed individually in cages and maintained in a controlled environment with day-night cycles of 12 hours, a relative humidity of 40%–70%, and a temperature of 21–25°C.
Weight and food intake
In this study, weight was measured after 6 hours of fasting. Preoperative and postoperative weight are shown in Fig. 1. DJB had mild weight loss during the postoperative period compared with control animals (P<.01 at the second week, P<.05 at the fourth week with no statistical significance but had trends at the eighth week). Furthermore, compared with DJB and sham animals, the weight of RYGB animals was significantly lower at all measuring time points postoperatively (P<.0001 RYGB versus
Discussion
The present study investigated the effectiveness of gastric volume reduction in addition to intestinal bypass on glycemic control and whole body metabolic changes in nonobese diabetic rats. We found that RYGB preceded DJB in the remission of T2D in these animals. In addition, RYGB animals had elevated energy expenditure and higher adipolysis. RYGB surgery removed about 95% of the stomach volume in these rats, which drastically decreased their food intake and significantly increased weight loss
Conclusion
In the present study, RYGB procedure precedes DJB in remission of T2D in a nonobese T2D GK rat model. In addition, metabolic rate and adipolysis were also increased more in the RYGB group, especially during the resting period. These findings indicated that intestinal bypass was unable to achieve full remission of hyperglycemia. Furthermore, adding gastric volume reduction to intestine bypass gives better efficacy and is essential in the remission of T2D, even in nonobese patients.
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
Acknowledgments
Thanks to Yueqian Wang, Lili Gao, and Yongjun Liang for assistance with the experiments and to Tingfeng Wang for a valuable discussion. This study was supported by the Shanghai Bureau of Health and Family Planning Grant (Grant No. 20124443), Shanghai Commission of Science and Technology Grant (Grant No.124119 b1800), and Shanghai Pujiang Telant Project Grant (No. 14 PJ1407800), as well as Pudong Bureau of Health and Family Planning Grants (Grant No. PwRd2013-08, No. PWZxq2014-08). This support
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