Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Obesity Surgery
Erschienen in: Obesity Surgery 12/2012

01.12.2012 | Animal Research

Type 2 Diabetes Control in a Nonobese Rat Model Using Sleeve Gastrectomy with Duodenal–Jejunal Bypass (SGDJB)

verfasst von: Dong Sun, Shaozhuang Liu, Guangyong Zhang, Weijie Chen, Zhibo Yan, Sanyuan Hu

Erschienen in: Obesity Surgery | Ausgabe 12/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

As a new bariatric procedure, sleeve gastrectomy with duodenal–jejunal bypass (SGDJB) needs further assessment. We compared the diabetic control between SGDJB and sleeve gastrectomy (SG) in Goto–Kakizaki (GK) rats, a nonobese rat model of type 2 diabetes. Our aim is firstly to develop a nonobese diabetic rat model for SGDJB and secondly to investigate the feasibility and safety of SGDJB to induce diabetes remission.

Methods

Fifty 11-week-old male GK rats were divided into five groups: sham-operated SG (SOSG), sham-operated SGDJB (SOSGDJB), control, SG, and SGDJB. Rats were observed for 16 weeks after surgery. The body weight, food intake, glycemic control outcomes, ghrelin, peptide YY (PYY), insulin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic peptide were measured.

Results

The operated groups showed lower food intake since 4 weeks postoperation and significant weight loss since 6 weeks postoperation. SGDJB and SG surgeries induced a decreased fasting ghrelin level and increased levels of glucose-stimulated insulin, GLP-1, and PYY secretion at 2 and 16 weeks postoperation. Compared with the SG group, the SGDJB group showed higher glucose-stimulated GLP-1 levels. Both SGDJB and SG groups exhibited significant improvement in oral glucose tolerance and insulin tolerance compared with sham-operated and control groups, but there was no difference between the operated groups.

Conclusions

This nonobese diabetic rat model may be valuable in studying the effect of SGDJB on diabetic control. SGDJB shows similar improvement of glucose metabolism with SG. Our findings do not provide evidence for the foregut-mediated amelioration in glucose homeostasis.
Literatur
1.
Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef
2.
Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222(3):339–50. discussion 350–2.PubMedCrossRef
3.
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef
4.
Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56. e5.PubMedCrossRef
5.
Buchwald H, Oien DM. Metabolic/Bariatric Surgery Worldwide 2008. Obes Surg. 2009;19(12):1605–11.PubMedCrossRef
6.
Boza C, Gagner M, Devaud N, et al. Laparoscopic sleeve gastrectomy with ileal transposition (SGIT): a new surgical procedure as effective as gastric bypass for weight control in a porcine model. Surg Endosc. 2008;22(4):1029–34.PubMedCrossRef
7.
Alexander JW, Hawver LRM, Goodman HR. Banded sleeve gastrectomy—initial experience. Obes Surg. 2009;19(11):1591–6.PubMedCrossRef
8.
Aguirre V, Stylopoulos N, Grinbaum R, et al. An endoluminal sleeve induces substantial weight loss and normalizes glucose homeostasis in rats with diet-induced obesity. Obesity (Silver Spring). 2008;16(12):2585–92.CrossRef
9.
del Genio G, Gagner M, Cuenca-Abente F, et al. Laparoscopic sleeve gastrectomy with duodeno-jejunal bypass: a new surgical procedure for weight control. Feasibility and safety study in a porcine model. Obes Surg. 2008;18(10):1263–7.PubMedCrossRef
10.
Kasama K, Tagaya N, Kanehira E, et al. Laparoscopic sleeve gastrectomy with duodenojejunal bypass: technique and preliminary results. Obes Surg. 2009;19(10):1341–5.PubMedCrossRef
11.
Gan SS, Talbot ML, Jorgensen JO. Efficacy of surgery in the management of obesity-related type 2 diabetes mellitus. ANZ J Surg. 2007;77(11):958–62.PubMedCrossRef
12.
Pereferrer FS, Gonzalez MH, Rovira AF, et al. Influence of sleeve gastrectomy on several experimental models of obesity: metabolic and hormonal implications. Obes Surg. 2008;18(1):97–108.PubMedCrossRef
13.
Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg. 2006;244(5):741–9.PubMedCrossRef
14.
Rubino F, Marescaux J. Effect of duodenal–jejunal exclusion in a non-obese animal model of type 2 diabetes—a new perspective for an old disease. Ann Surg. 2004;239(1):1–11.PubMedCrossRef
15.
Cohen RV, Schiavon CA, Pinheiro JS, et al. Duodenal–jejunal bypass for the treatment of type 2 diabetes in patients with body mass index of 22–34 kg/m(2): a report of 2 cases. Surg Obes Relat Dis. 2007;3(2):195–7.PubMedCrossRef
16.
Ramos AC, Galvao Neto MP, de Souza YM, et al. Laparoscopic duodenal–jejunal exclusion in the treatment of type 2 diabetes mellitus in patients with BMI <30 kg/m2 (LBMI). Obes Surg. 2009;19(3):307–12.PubMedCrossRef
17.
Praveen Raj P, Kumaravel R, Chandramaliteeswaran C, et al. Is laparoscopic duodenojejunal bypass with sleeve an effective alternative to roux en y gastric bypass in morbidly obese patients: preliminary results of a randomized trial. Obes Surg. 2012;22(3):422–6.PubMedCrossRef
18.
Navarrete SA, Leyba JL, Llopis SN. Laparoscopic sleeve gastrectomy with duodenojejunal bypass for the treatment of type 2 diabetes in non-obese patients: technique and preliminary results. Obes Surg. 2011;21(5):663–7.PubMedCrossRef
19.
Gagner M. Laparoscopic sleeve gastrectomy with duodenojejunal bypass for severe obesity and/or type 2 diabetes may not require duodenojejunal bypass initially. Obes Surg. 2010;20(9):1323–4.PubMedCrossRef
20.
de Bona Castelan J, Bettiol J, d’Acampora AJ, et al. Sleeve gastrectomy model in Wistar rats. Obes Surg. 2007;17(7):957–61.PubMedCrossRef
21.
Schlager A, Khalaileh A, Mintz Y, et al. A mouse model for sleeve gastrectomy: applications for diabetes research. Microsurgery. 2011;31(1):66–71.PubMedCrossRef
22.
Li F, Zhang G, Liang J, et al. Sleeve gastrectomy provides a better control of diabetes by decreasing ghrelin in the diabetic Goto–Kakizaki rats. J Gastrointest Surg. 2009;13(12):2302–8.PubMedCrossRef
23.
Mattews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.CrossRef
24.
Sjostrom CD, Lissner L, Wedel H, et al. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res. 1999;7(5):477–84.PubMed
25.
Ferchak CV, Meneghini LF. Obesity, bariatric surgery and type 2 diabetes—a systematic review. Diabetes Metab Res Rev. 2004;20(6):438–45.PubMedCrossRef
26.
Tice JA, Karliner L, Walsh J, et al. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med. 2008;121(10):885–93.PubMedCrossRef
27.
Karra E, Yousseif A, Batterham RL. Mechanisms facilitating weight loss and resolution of type 2 diabetes following bariatric surgery. Trends Endocrinol Metab. 2010;21(6):337–44.PubMedCrossRef
28.
Pournaras DJ, Osborne A, Hawkins SC, et al. Remission of type 2 diabetes after gastric bypass and banding: mechanisms and 2 year outcomes. Ann Surg. 2010;252(6):966–71.PubMedCrossRef
29.
Korbonits M, Goldstone AP, Gueorguiev M, et al. Ghrelin—a hormone with multiple functions. Front Neuroendocrinol. 2004;25(1):27–68.PubMedCrossRef
30.
Peng Z, Xiaolei Z, Al-Sanaban H, et al. Ghrelin inhibits insulin release by regulating the expression of inwardly rectifying potassium channel 6.2 in islets. Am J Med Sci. 2012;343(3):215–9.PubMedCrossRef
31.
Tymitz K, Engel A, McDonough S, et al. Changes in ghrelin levels following bariatric surgery: review of the literature. Obes Surg. 2011;21(1):125–30.PubMedCrossRef
32.
Bohdjalian A, Langer FB, Shakeri-Leidenmuehler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.PubMedCrossRef
33.
34.
Strader AD, Vahl TP, Jandacek RJ, et al. Weight loss through ileal transposition is accompanied by increased ileal hormone secretion and synthesis in rats. Am J Physiol Endocrinol Metab. 2005;288(2):E447–53.PubMedCrossRef
35.
Pacheco D, Antonio de Luis D, Romero A, et al. The effects of duodenal–jejunal exclusion on hormonal regulation of glucose metabolism in Goto–Kakizaki rats. Am J Surg. 2007;194(2):221–4.PubMedCrossRef
36.
Wang TT, Hu SY, Gao HD, et al. Ileal transposition controls diabetes as well as modified duodenal jejunal bypass with better lipid lowering in a nonobese rat model of type II diabetes by increasing GLP-1. Ann Surg. 2008;247(6):968–75.PubMedCrossRef
37.
Mingrone G. Role of the incretin system in the remission of type 2 diabetes following bariatric surgery. Nutr Metab Cardiovasc Dis. 2008;18(8):574–9.PubMedCrossRef
38.
Amori RE, Lau J, Pittas AG. Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis. JAMA. 2007;298(2):194–206.PubMedCrossRef
39.
Lee HC, Kim MK, Kwon HS, et al. Early changes in incretin secretion after laparoscopic duodenal–jejunal bypass surgery in type 2 diabetic patients. Obes Surg. 2010;20(11):1530–5.PubMedCrossRef
40.
Basso N, Capoccia D, Rizzello M, et al. First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: the gastric hypothesis. Surg Endosc. 2011;25(11):3540–50.PubMedCrossRef
41.
Masuda T, Ohta M, Hirashita T, et al. A comparative study of gastric banding and sleeve gastrectomy in an obese diabetic rat model. Obes Surg. 2011;21(11):1774–80.PubMedCrossRef
42.
Strader AD, Clausen TR, Goodin SZ, et al. Ileal interposition improves glucose tolerance in low dose streptozotocin-treated diabetic and euglycemic rats. Obes Surg. 2009;19(1):96–104.PubMedCrossRef
43.
Chelikani PK, Shah IH, Taqi E, et al. Comparison of the effects of Roux-en-Y gastric bypass and ileal transposition surgeries on food intake, body weight, and circulating peptide YY concentrations in rats. Obes Surg. 2010;20(9):1281–8.PubMedCrossRef
44.
De Silva A, Bloom SR. Gut hormones and appetite control: a focus on PYY and GLP-1 as therapeutic targets in obesity. Gut Liver. 2012;6(1):10–20.PubMedCrossRef
45.
Chelikani PK, Haver AC, Reeve JR, et al. Daily, intermittent intravenous infusion of peptide YY(3–36) reduces daily food intake and adiposity in rats. Am J Physiol Regul Integr Comp Physiol. 2006;290(2):R298–305.PubMedCrossRef
46.
Sileno AP, Brandt GC, Spann BM, et al. Lower mean weight after 14 days intravenous administration peptide YY3–36 (PYY3–36) in rabbits. Int J Obes (Lond). 2006;30(1):68–72.CrossRef
47.
Chelikani PK, Haver AC, Reidelberger RD. Intermittent intraperitoneal infusion of peptide YY(3–36) reduces daily food intake and adiposity in obese rats. Am J Physiol Regul Integr Comp Physiol. 2007;293(1):R39–46.PubMedCrossRef
48.
Reidelberger RD, Haver AC, Chelikani PK, et al. Effects of different intermittent peptide YY (3–36) dosing strategies on food intake, body weight, and adiposity in diet-induced obese rats. Am J Physiol Regul Integr Comp Physiol. 2008;295(2):R449–58.PubMedCrossRef
49.
Nadkarni PP, Costanzo RM, Sakagami M. Pulmonary delivery of peptide YY for food intake suppression and reduced body weight gain in rats. Diabetes Obes Metab. 2011;13(5):408–17.PubMedCrossRef
50.
van den Hoek AM, Heijboer AC, Voshol PJ, et al. Chronic PYY3–36 treatment promotes fat oxidation and ameliorates insulin resistance in C57BL6 mice. Am J Physiol Endocrinol Metab. 2007;292(1):E238–45.PubMedCrossRef
Metadaten
Titel
Type 2 Diabetes Control in a Nonobese Rat Model Using Sleeve Gastrectomy with Duodenal–Jejunal Bypass (SGDJB)
verfasst von
Dong Sun
Shaozhuang Liu
Guangyong Zhang
Weijie Chen
Zhibo Yan
Sanyuan Hu
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 12/2012
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0744-7

Weitere Artikel der Ausgabe 12/2012

Obesity Surgery 12/2012 Zur Ausgabe

Letter to the Editor

Response to Comment About the Paper by Hayes et al., Obes. Surg. 2011, by Charles Mithieux

Clinical Research

Laparoscopic Roux-en-Y Vs. Mini-gastric Bypass for the Treatment of Morbid Obesity: a 10-Year Experience

Clinical Report

Repeat Sleeve Gastrectomy Compared with Primary Sleeve Gastrectomy: A Single-Center, Matched Case Study

Letter to the Editor

Response to Letter to the Editor from Maureen McCormick: Obesity and Inflammation: Change in Adiponectin, C-Reactive Protein, Tumour Necrosis Factor-Alpha and Interleukin-6 After Bariatric Surgery

Clinical Research

Management of Gastric Perforations During Laparoscopic Gastric Banding

Clinical Research

What are Gastric Banding Patients Eating One Year Post-Surgery?

Neu im Fachgebiet Chirurgie

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Hochrisiko-Eingriffe für postoperative Übelkeit

16.04.2024 | Infektiologie | Nachrichten

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

10.04.2024 | Postoperative Schmerztherapie | Nachrichten

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

10.04.2024 | Narbenhernie | Nachrichten

Deutlich weniger Narbenhernien mit der Small-Bites-Technik
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom CME-Kurs
CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur CME-Kurs
CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis CME-Kurs
CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.