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Side-to-Side Jejunoileal Bypass Induces Better Glucose-Lowering Effect than End-to-Side Jejunoileal Bypass on Nonobese Diabetic Rats

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Abstract

Background

Jejunoileal bypass (JIB) can markedly ameliorate diabetes in obese patients and rodents. The aim of this study is to systematically evaluate the role of the operational manner and the retained distal small bowel length in mediating changes in glucose homeostasis after intestinal bypass surgeries in nonobese diabetic rats.

Methods

Streptozotocin-induced diabetic rats underwent side-to-side jejunoileal bypass plus proximal loop ligation (SSJIBL), end-to-side jejunoileal bypass (ESJIB), proximal small bowel resection (PBR), and sham operation. Each operational manner included two subgroups, in which 30 cm (L-30) or 40 cm (L-40) distal small bowel was retained. Main outcome measures were fasting blood glucose levels (FBG), insulin sensitivity, serum insulin, glucagon-like peptide-1 (GLP-1), bilirubin (BIL), and total bile acids (TBA) levels.

Results

Global food intake in the sham group was higher than in the operation groups, and global body weight and food intake in the SSJIBL group were higher than in the ESJIB and PBR groups. Global body weight and food intake in L-40 group were higher than in L-30 group. The SSJIBL procedure induced better improvement in glucose homeostasis and insulin sensitivity than the ESJIB and PBR procedures, and L-30 group showed better antidiabetic effects than L-40 group. Serum GLP-1, BIL, and TBA levels in SSJIBL group were higher than in ESJIB and PBR groups.

Conclusions

This study shows that side-to-side jejunoileal bypass induced better glucose-lowering effects than end-to-side jejunoileal bypass and proximal small bowel resection, and intestinal bypass surgery that retained shorter distal small bowel yielded better antidiabetic effects.

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Conflict of Interest

All authors declare to have no conflict of interest.

Statement of Informed Consent

Informed consent does not apply to the study.

Statement of Animal Rights

All applicable institutional and/or national guidelines for the care and use of animals were followed. The experiments were carried out in accordance with and were approved by the Ethical Committee on Animal Experimentation of Xiangya Medical College, Central South University of Science and Technology, China (Permit number: S249).

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Authors and Affiliations

  1. Department of General Surgery, The First Affiliated Hospital of Soochow University, No.188 Shizi Road, Suzhou, Jiangsu Province, 215006, People’s Republic of China

    Jinyuan Duan

  2. Department of Women’s Health, Maternal and Child Health Hospital of Jiangxi Province, Nanchang, 330006, China

    Cai Tan

  3. Department of Breast and Thyroid Surgery, Haikou Peoples’s Hospital, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, China

    Hang Xu

  4. Department of Intestinal Surgery, Hunan Provincial Tumor Hospital, The Affiliated Tumor Hospital of Central South University Xiangya School of Medicine, Changsha, 410013, China

    Shaolin Nie

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  1. Jinyuan Duan
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  2. Cai Tan
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  3. Hang Xu
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  4. Shaolin Nie
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Correspondence to Jinyuan Duan.

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Duan, J., Tan, C., Xu, H. et al. Side-to-Side Jejunoileal Bypass Induces Better Glucose-Lowering Effect than End-to-Side Jejunoileal Bypass on Nonobese Diabetic Rats. OBES SURG 25, 1458–1467 (2015). https://doi.org/10.1007/s11695-014-1549-7

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  • DOI: https://doi.org/10.1007/s11695-014-1549-7

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