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Expedited Biliopancreatic Juice Flow to the Distal Gut Benefits the Diabetes Control After Duodenal-Jejunal Bypass

Obesity Surgery volume 25, pages 1802–1809 (2015)Cite this article

Abstract

Background

Serum bile acids (BAs) are elevated after metabolic surgeries including Roux-en-Y gastric bypass (RYGB), ileal transposition (IT), and duodenal-jejunal bypass (DJB). Recently, BAs have emerged as a kind of signaling molecules, which can not only promote glucagon-like peptide-1 (GLP-1) secretion but can also regulate multiple enzymes involved in glucose metabolism. The aim of this study was to investigate whether expedited biliopancreatic juice flow to the distal gut contributes to the increased serum GLP-1 and BAs and benefits the diabetes control after DJB.

Methods

DJB, long alimentary limb DJB (LDJB), duodenal-jejunal anastomosis (DJA), and sham operation were performed in diabetic rats induced by high-fat diet (HFD) and low dose of streptozotocin (STZ). Body weight, food intake, oral glucose tolerance, insulin tolerance, glucose-stimulated insulin and GLP-1 secretion, fasting serum total bile acids (TBAs), and lipid profiles were measured at indicated time points.

Results

Compared with sham operation, DJA, DJB, and LDJB all achieved rapid and dramatic improvements in glucose tolerance and insulin sensitivity independently of food restriction and weight loss. DJB and LDJB-operated rats exhibited even better glucose tolerance, higher fasting serum TBAs, and higher glucose-stimulated GLP-1 secretion than the DJA group postoperatively. No difference was detected in insulin sensitivity and glucose-stimulated insulin secretion between DJA, DJB, and LDJB groups.

Conclusions

Expedited biliopancreatic juice flow to the distal gut was associated with augmented GLP-1 secretion and increased fasting serum TBA concentration, which may partly explain the metabolic benefits of DJB.

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Acknowledgments

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.

Conflict of Interest

We declare that all authors have no conflict of interest.

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Statement of Human and Animal Rights

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

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Author notes

    Affiliations

    1. Department of General Surgery, Qilu Hospital of Shandong University, 107 West Wenhua Road, Jinan, 250012, Shandong, People’s Republic of China

      Haifeng Han, Lei Wang, Jianjun Jiang, Chunxiao Hu, Guangyong Zhang, Shaozhuang Liu, Xiang Zhang, Teng Liu & Sanyuan Hu

    2. School of Medicine, Shandong University, 44 West Wenhua Road, Jinan, 250012, Shandong, People’s Republic of China

      Hao Du

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    1. Haifeng Han
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    Correspondence to Sanyuan Hu.

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    Haifeng Han and Lei Wang contributed equally to this work.

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    Han, H., Wang, L., Du, H. et al. Expedited Biliopancreatic Juice Flow to the Distal Gut Benefits the Diabetes Control After Duodenal-Jejunal Bypass. OBES SURG 25, 1802–1809 (2015). https://doi.org/10.1007/s11695-015-1633-7

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    Keywords

    • Duodenal-jejunal bypass
    • Type 2 diabetes mellitus
    • Bile acids
    • Glucagon-like peptide-1
    • Insulin