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Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model

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Abstract

Background

Sleeve gastrectomy plus side-to-side jejunoileal anastomosis (JI-SG), a relatively new approach to bariatric surgeries, has shown promising results for treating obesity and metabolic comorbidities. This study investigated the feasibility and safety of JI-SG in weight loss and diabetes remission compared with sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB).

Methods

Forty 10-week-old male Zucker diabetic fatty rats were randomly assigned to four groups: control, SG, JI-SG, and RYGB. Their body weights, food intake, and levels of gut hormones (ghrelin, insulin, and glucagon-like peptide-1 (GLP-1)) and lipids were measured.

Results

Rats in the SG, JI-SG, and RYGB groups demonstrated lower food intake and more weight loss 2 weeks postoperatively compared with control rats. Furthermore, rats in the JI-SG group achieved more weight loss (mean 242.7 ± 11.2 g) compared with those in the SG and RYGB groups (SG, 401.4 ± 15.1 g and RYGB, 298 ± 12 g, both P < 0.01). All surgery groups demonstrated a decreased fasting insulin, serum glucose, lipid levels, and increased GLP-1 postoperatively. The JI-SG group had lower fasting ghrelin levels than the RYGB group (168 ± 19.8 ng/L vs. 182 ± 16.7 ng/L, P < 0.01) and higher fasting GLP-1 levels than the SG group (1.99 ± 0.11 pmol/L vs. 1.71 ± 0.12 pmol/L, P < 0.01) at 12 weeks postoperatively. Over the experimental period, the ghrelin levels slowly increased in all surgical groups but remained lower than the preoperative and control levels.

Conclusions

JI-SG induced higher ghrelin and GLP-1 levels and improved glycemic control in Zucker diabetic fatty rats. Compared with SG and RYGB, JI-SG appeared to be a simple, relatively safe, and more effective procedure for treating type 2 diabetes and obesity in this animal model.

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Disclosures

Authors’ contributions

KJW and XGZ were responsible for the study conception and design, analyses and interpretation of the data, and drafting of the manuscript. GQ, JJL, WG, and AAX generated the experimental data. KJW and JFZ provided advice on the study concept, conducted specific analyses, and critically revised the manuscript. JFZ is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

This study was funded by the Health Bureau of Pudong New Area (Shanghai, pw2013A-3).

Conflict of Interest

The authors declare that they have no competing interests.

Statement of Animal Rights

The Animal Care and Utilization Committee of Tongji University approved all animal experiments in this study. All animals were housed under standard conditions with free access to water and food.

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Author notes

    Authors and Affiliations

    1. Department of General Surgery, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092, China

      Kaijing Wang

    2. Department of Bariatric and Metabolic Surgery, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai, 200120, China

      Xiaogang Zhou, Jiajun Lu, Wei Gao, Anan Xu & Jiangfan Zhu

    3. Department of General Surgery, Oakwood Southshore Medical Center, Trenton, MI, USA

      Giang Quach

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    1. Kaijing Wang
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    Correspondence to Jiangfan Zhu.

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    Kaijing Wang and Xiaogang Zhou contributed equally to this work.

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    Wang, K., Zhou, X., Quach, G. et al. Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model. OBES SURG 26, 797–804 (2016). https://doi.org/10.1007/s11695-015-1811-7

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