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Obesity Surgery

, Volume 28, Issue 12, pp 4014–4021 | Cite as

Comparison of Great Curvature Plication with Duodenal-Jejunal Bypass (GCP-DJB) and Sleeve Gastrectomy (SG) on Metabolic Indices and Gut Hormones in Type 2 Diabetes Mellitus Rats

  • Nian-Cun Qiu
  • Wei Li
  • Miao-E Liu
  • Xiao-Xia Cen
  • Cheng-Xiang Shan
  • Wei Zhang
  • Qing Liu
  • Yang Wang
  • Ya-Ting Zhu
  • Ming Qiu
Original Contributions
  • 174 Downloads

Abstract

Objective

The present study compared the therapeutic effects of great curvature plication with duodenal-jejunal bypass (GCP-DJB) and the commonly used sleeve gastrectomy (SG) in rats with type 2 diabetes mellitus (T2DM).

Methods

The rats were randomly divided into three groups: Control group (n = 6), SG group (n = 6), and GCP-DJB group (n = 6). Body weight, daily food intake, fasting blood glucose level, fasting insulin level, insulin resistance index, and fasting serum concentrations of glucagon-like peptide-1 (GLP-1), peptide tyrosine tyrosine (PYY), and bile acid were measured. In addition, postoperative changes in body weight and daily food intake at 2, 4, 6, 8, 10, and 12 weeks were also recorded. At week 12, an oral glucose tolerance test (OGTT) and insulin release test were performed to determine glucose tolerance. The insulin resistance index (IRI) was also measured. The postprandial secretion curves and area under the curve (AUC) of GLP-1, gastric inhibitory polypeptide (GIP), PYY, and bile acid were also calculated.

Results

Before surgery, no significant differences in body weight, daily food intake, fasting blood glucose, fasting insulin, insulin resistance index, fasting GLP-1, PYY, and bile acid were found among the three groups (P > 0.05). At postoperative week 12, body weight and food intake in the SG and GCP-DJB groups were lower than those in the Control group (P < 0.05), and body weight in the GCP-DJB group was lowest (P < 0.05). Glucose tolerance, postprandial serum insulin (INS), GLP-1, PYY, and bile acid were significantly higher in the SG and GCP-DJB groups than in the Control group (P < 0.05). The parameters related to glucose metabolism in the GCP-DJB group were higher than those in the SG group with the exception of serum insulin (P < 0.05). In addition, IRI and GIP secretion were significantly lower in the SG and GCP-DJB groups than in the Control group (P < 0.05) and were lowest in the GCP-DJB group (P < 0.05).

Conclusion

Both GCP-DJB and SG are surgical options for the treatment of T2DM. The underlying mechanism of these treatments may be related to the decrease in body weight, food intake, GIP, IRI, and the increase in INS, GLP-1, PYY, and bile acid. According to the various metabolic indicators related to the hypoglycemic effects in T2DM, GCP-DJB was superior to SG.

Keywords

Type 2 diabetes mellitus Metabolic surgery Therapeutic effects 

Notes

Author Contribution

Nian-Cun Qiu, Wei Li, and Miao-E Liu had the original conception, carried out the experimental work, and wrote the article. Xiao-Xia Cen and Qing Liu participated in the data analysis and interpretation. Cheng-Xiang Shan and Wei Zhang participated in data collection and coordination of experimental work. Yang Wang, Ya-Ting Zhu, and Ming Qiu were involved in the revision of the article. Yang Wang and Ya-Ting Zhu were Corresponding authors. All authors had read and approved the final manuscript.

Funding Information

This work was supported by grants from the NSFC (Natural Science Foundation of China) No. 81300723, No. 81270969, and No. 81370984.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from individual participants included in the study.

Animal Rights Statement and Ethical Approval

This study was approved by the Animal Ethics Committee of Changzheng Hospital Affiliated to the Secondary Military Medical University. For this type of study, formal consent is not required.

References

  1. 1.
    Surgery CSfMB. Guidelines for surgical treatment of obesity and type 2 diabetes in China. Chin J Pract Surg. 2014;2014(11):1005–10.Google Scholar
  2. 2.
    Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefGoogle Scholar
  3. 3.
    Lee WJ, Aung L. Metabolic surgery for type 2 diabetes mellitus: experience from Asia. Diabetes Metab J. 2016;40(6):433–43.CrossRefGoogle Scholar
  4. 4.
    Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: state of the art. Nat Rev Gastroenterol Hepatol. 2017;14(3):160–9.CrossRefGoogle Scholar
  5. 5.
    Dixon JB, Hur KY, Lee WJ, et al. Gastric bypass in type 2 diabetes with BMI < 30: weight and weight loss have a major influence on outcomes. Diabet Med. 30(4):e127–34.CrossRefGoogle Scholar
  6. 6.
    Qiu NC, Cen XX, Liu ME, et al. Greater curvature plication with duodenal-jejunal bypass: a novel metabolic surgery for type 2 diabetes mellitus. Obes Surg. Google Scholar
  7. 7.
    Hao Z, Townsend RL, Mumphrey MB, et al. RYGB produces more sustained body weight loss and improvement of glycemic control compared with VSG in the diet-induced obese mouse model. Obes Surg. 2017;27(9):2424–33.CrossRefGoogle Scholar
  8. 8.
    Zhou D, Jiang X, Ding W, et al. Impact of bariatric surgery on ghrelin and obestatin levels in obesity or type 2 diabetes mellitus rat model. J Diabetes Res. 2014;2014:569435.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Yska JP, van Roon EN, de Boer A, et al. Remission of type 2 diabetes mellitus in patients after different types of bariatric surgery: a population-based cohort study in the United Kingdom. JAMA Surg. 2015;150(12):1126–33.CrossRefGoogle Scholar
  10. 10.
    Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146(2):143–8.CrossRefGoogle Scholar
  11. 11.
    Romero F, Nicolau J, Flores L, et al. Comparable early changes in gastrointestinal hormones after sleeve gastrectomy and Roux-En-Y gastric bypass surgery for morbidly obese type 2 diabetic subjects. Surg Endosc. 2012;26(8):2231–9.CrossRefGoogle Scholar
  12. 12.
    Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefGoogle Scholar
  13. 13.
    Cho HJ, Kosari S, Hunne B, et al. Differences in hormone localisation patterns of K and L type enteroendocrine cells in the mouse and pig small intestine and colon. Cell Tissue Res. 2015;359(2):693–8.CrossRefGoogle Scholar
  14. 14.
    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.CrossRefGoogle Scholar
  15. 15.
    Patriti A, Aisa MC, Annetti C, et al. How the hindgut can cure type 2 diabetes. Ileal transposition improves glucose metabolism and beta-cell function in Goto-Kakizaki rats through an enhanced Proglucagon gene expression and L-cell number. Surgery. 2007;142(1):74–85.CrossRefGoogle Scholar
  16. 16.
    Vetter ML, Cardillo S, Rickels MR, et al. Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Ann Intern Med. 2009;150(2):94–103.CrossRefGoogle Scholar
  17. 17.
    Kohli R, Setchell KD, Kirby M, et al. A surgical model in male obese rats uncovers protective effects of bile acids post-bariatric surgery. Endocrinology. 2013;154(7):2341–51.CrossRefGoogle Scholar
  18. 18.
    Pournaras DJ, Glicksman C, Vincent RP, et al. The role of bile after Roux-en-Y gastric bypass in promoting weight loss and improving glycaemic control. Endocrinology. 2012;153(8):3613–9.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nian-Cun Qiu
    • 1
    • 2
  • Wei Li
    • 2
  • Miao-E Liu
    • 3
  • Xiao-Xia Cen
    • 2
  • Cheng-Xiang Shan
    • 2
  • Wei Zhang
    • 2
  • Qing Liu
    • 1
  • Yang Wang
    • 4
    • 5
  • Ya-Ting Zhu
    • 1
    • 5
  • Ming Qiu
    • 2
  1. 1.Department of General SurgeryHainan Branch of Chinese PLA General HospitalSanyaChina
  2. 2.Department of General SurgeryChang Zheng Hospital affiliated to Second Military Medical UniversityShanghaiChina
  3. 3.Key Laboratory of Reproductive Genetics, Women’s HospitalZhejiang UniversityZhejiangChina
  4. 4.Department of Hepatobiliary and Pancreatic Surgical OncologyChinese PLA General HospitalBeijingChina
  5. 5.BeijingChina

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