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

Obesity Surgery volume 26, pages 1565–1575 (2016)Cite this article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgements

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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Affiliations

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

    Xiang Zhang, Teng Liu, Yanmin Wang, Mingwei Zhong, Guangyong Zhang, Shaozhuang Liu & Sanyuan Hu

  2. Discipline of Medicine, The University of Adelaide, Level 6 Eleanor Harrald Building, Royal Adelaide Hospital, Frome Road, Adelaide, SA, Australia

    Xiang Zhang, Tongzhi Wu & Christopher K. Rayner

Authors
  1. Xiang Zhang
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  2. Teng Liu
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  3. Yanmin Wang
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  4. Mingwei Zhong
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  5. Guangyong Zhang
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  6. Shaozhuang Liu
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  7. Tongzhi Wu
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  9. Sanyuan Hu
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Correspondence to Sanyuan Hu.

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

Funding

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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Zhang, X., Liu, T., Wang, Y. et al. Comparative Effects of Bile Diversion and Duodenal-Jejunal Bypass on Glucose and Lipid Metabolism in Male Diabetic Rats. OBES SURG 26, 1565–1575 (2016). https://doi.org/10.1007/s11695-015-1925-y

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Keywords

  • Duodenal-jejunal bypass
  • Bile diversion
  • Diabetes mellitus
  • Bile acids