Obesity Surgery

, Volume 26, Issue 7, pp 1565–1575 | Cite as

Comparative Effects of Bile Diversion and Duodenal-Jejunal Bypass on Glucose and Lipid Metabolism in Male Diabetic Rats

  • Xiang Zhang
  • Teng Liu
  • Yanmin Wang
  • Mingwei Zhong
  • Guangyong Zhang
  • Shaozhuang Liu
  • Tongzhi Wu
  • Christopher K. Rayner
  • Sanyuan HuEmail author
Original Contributions



Duodenal-jejunal bypass (DJB) induces rapid and durable improvement in glucose and lipid metabolism. Besides bypassing the proximal gut, DJB also diverts bile acids (BAs) into the distal gut, increasing luminal and systemic BAs that are essential to metabolic homeostasis. The aim of this study is to evaluate whether bile diversion (BD) alone can recapitulate the effects of DJB on glucose and lipid metabolism.


BD, DJB and SHAM procedures were performed in a diabetic rat model induced by high-fat diet (HFD)/streptozotocin (STZ). Body weight, energy intake, blood glucose, serum hormones, insulin sensitivity, lipid profiles, and luminal and systemic BAs were measured postsurgery.


BD reduced body weight, independently of energy intake, whereas DJB had no effects. Luminal and serum BAs were increased after both DJB and BD, and were higher after BD than DJB. During glucose tolerance test, both fasting and postprandial blood glucose concentrations were reduced with DJB and BD, and were lower after DJB than BD. Insulin sensitivity was improved after DJB, but remained unchanged after BD. Fasting and postprandial GLP-1 were equally increased after DJB and BD. Serum triglyceride and free fatty acids were decreased more after BD than DJB, while hepatic triglyceride storage was reduced more after DJB.


These observations indicate that BD, which increases luminal and systemic BAs and postprandial GLP-1, represents an important component of DJB in restoring glucose and lipid homeostasis in diabetic state. However, other mechanisms associated with DJB also appear to make complementary contributions to metabolic regulation.


Duodenal-jejunal bypass Bile diversion Diabetes mellitus Bile acids 



This work was supported by the National Natural Science Foundation of China (no. 81270888/H0713, no. 81370496/H0308, no. 81300286/H0308), Natural Science Foundation of Shandong Province grants (no. ZR2009CM051), and the Taishan Scholar Foundation. Dr. T Wu is supported by a Royal Adelaide Hospital Research Committee Early Career Fellowship.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing intersets.

Statement of Informed Consent

Does not apply.

Statement of Human and Animal Rights

All applicable institutional and national guidelines for the care and use of animals were followed.


This work was supported by the National Natural Science Foundation of China (no. 81270888/H0713, no. 81370496/H0308, no. 81300286/H0308), Natural Science Foundation of Shandong Province grants (no. ZR2009CM051), and the Taishan Scholar Foundation. Dr. T Wu is supported by a Royal Adelaide Hospital Research Committee Early Career Fellowship.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Xiang Zhang
    • 1
    • 2
  • Teng Liu
    • 1
  • Yanmin Wang
    • 1
  • Mingwei Zhong
    • 1
  • Guangyong Zhang
    • 1
  • Shaozhuang Liu
    • 1
  • Tongzhi Wu
    • 2
  • Christopher K. Rayner
    • 2
  • Sanyuan Hu
    • 1
    Email author
  1. 1.Department of General SurgeryQilu Hospital of Shandong UniversityJinanPeople’s Republic of China
  2. 2.Discipline of MedicineThe University of AdelaideAdelaideAustralia

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