Obesity Surgery

, Volume 28, Issue 10, pp 3087–3094 | Cite as

Duodenum Exclusion Alone Is Sufficient to Improve Glucose Metabolism in STZ-Induced Diabetes Rats

  • Weihang Wu
  • Li Lin
  • Zhixiong Lin
  • Weijin Yang
  • Zhicong Cai
  • Jie Hong
  • Jiandong Qiu
  • Chen Lin
  • Nan LinEmail author
  • Yu WangEmail author
Original Contributions



Several studies have found that metabolic surgery can significantly improve glucose homeostasis; however, the intrinsic mechanisms remain unclear. Accumulating evidence suggests that duodenal bypass plays a crucial role in the treatment of type 2 diabetes mellitus (T2DM). Here, we aimed to evaluate the effect of duodenal reflux on glucose metabolism in T2DM.


A high-fat diet and low-dose streptozotocin (STZ) administration were used to induce T2DM in male rats, which were assigned to three experimental groups: sham operation (SO; n = 10), new duodenal-jejunal bypass (NDJB; n = 10), and new duodenal-jejunal bypass with a tube (NDJBT; n = 10). Weight, food intake, oral glucose tolerance test (OGTT) results, glucagon-like peptide 1 (GLP-1) levels, and histopathology were assessed before or after surgery. Plain abdominal radiography was performed 1 week after the operation.


Plain abdominal radiography indicated the occurrence of contrast agent reflux into the duodenum. The body weight and food intake in all three groups did not significantly differ before and after surgery. The NDJB and particularly the NDJBT groups exhibited better glucose tolerance, lower fasting blood glucose (FBG) levels, lower area under the curves for OGTT (AUCOGTT) values, and higher GLP-1 levels, as compared with the sham group postoperatively. The villus height and crypt depth were both shorter in the biliopancreatic limb after NDJBT, as compared with those after SO and NDJB.


Thus, exclusion of the duodenum alone and tube placement can effectively prevent duodenal reflux and improve glucose homeostasis, which further suggests that the duodenum plays an important role in T2DM.


Metabolic surgery New duodenal-jejunal bypass Reflux Radiography Intestinal histology 


Funding Information

This study was supported by the Fujian Provincial Key Science and Technology Project (2009Y0039), the Fujian Provincial Science Cooperation Project (2012I0007), and the Fujian Provincial Natural Science Fund Project (2017J01316).

Compliance with Ethical Standards

All study protocols were approved by the Animal Care and Utilization Committee of Comparative Medicine at Fuzhou General Hospital.

Conflict of Interest

The authors declare that they have no conflict of interest.

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.


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Copyright information

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

Authors and Affiliations

  • Weihang Wu
    • 1
  • Li Lin
    • 2
  • Zhixiong Lin
    • 2
  • Weijin Yang
    • 1
  • Zhicong Cai
    • 2
  • Jie Hong
    • 3
  • Jiandong Qiu
    • 2
  • Chen Lin
    • 1
  • Nan Lin
    • 1
    Email author
  • Yu Wang
    • 1
    • 4
    Email author
  1. 1.Department of General SurgeryFuzhou General Hospital of the PLAFuzhouChina
  2. 2.Clinical Institute of Fuzhou General HospitalFujian Medical UniversityFuzhouChina
  3. 3.Clinical Institute of Fuzhou General HospitalFujian University of Traditional Chinese MedicineFuzhouChina
  4. 4.Department of General Surgery, Dongfang HospitalXiamen UniversityFuzhouChina

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