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Amelioration of Glycemic Control by Sleeve Gastrectomy and Gastric Bypass in a Lean Animal Model of Type 2 Diabetes: Restoration of Gut Hormone Profile

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Abstract

Background

In obese diabetic patients, bariatric surgery has been shown to induce remission of type 2 diabetes. Along with weight loss itself, changes in gut hormone profiles after surgery play an important role in the amelioration of glycemic control. However, the potential of gastrointestinal surgery regarding diabetes remission in non-severely obese diabetic patients has yet to be defined. In the present experimental study, we explored the effect of established bariatric procedures with and without duodenal exclusion on glycemic control and gut hormone profile in a lean animal model of type 2 diabetes.

Methods

Forty 12- to 14-week-old non-obese diabetic Goto-Kakizaki (GK) rats were randomly assigned to four groups: control group (GKC), sham surgery (GKSS), sleeve gastrectomy (GKSG), and gastric bypass (GKGB). Age-matched Wistar rats served as a non-diabetic control group (WIC). Glycemic control and plasma lipids were assessed at the beginning of the observation period and 4 weeks after surgery. Fasting and mixed meal-induced plasma levels of ghrelin, glucagon-like peptide-17-36 (GLP-1), and peptide tyrosine-tyrosine (PYY) were measured.

Results

In GK rats, glycemic control improved after sleeve gastrectomy (SG) and gastric bypass (GB). Mixed meal-induced gut hormone profiles in Wistar rats (WIC) were significantly different from those of sham-operated or control group GK rats. After SG and GB, GK rats showed a similar postprandial decrease in ghrelin as observed in non-diabetic WIC. Following both surgical procedures, a significant meal-induced increase in PYY and GLP-1 could be demonstrated.

Conclusions

SG and GB induce a similar improvement in overall glycemic control in lean diabetic rodents. Meal-induced profiles of ghrelin, GLP-1, and PYY in GK rats are significantly modified by SG and GB and become similar to those of non-diabetic Wistar rats. Our data do not support the hypothesis that duodenal exclusion and early contact of food with the ileal mucosa alone explain changes in gut hormone profile in GK rats after gastrointestinal surgery.

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Conflict of Interest

Hans Eickhoff, Teresa Louro, Paulo Matafome, Filipa Vasconcelos, Raquel Seiça, and Francisco Castro e Sousa have no conflicts of interest to declare.

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Authors and Affiliations

  1. Obesity Center, Hospital de Santiago, EN 10, km 37, 2900-722, Setubal, Portugal

    Hans Eickhoff

  2. Institute of Physiology, Faculty of Medicine, Polo III, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548, Coimbra, Portugal

    Hans Eickhoff, Teresa M. Louro, Paulo N. Matafome, Filipa Vasconcelos & Raquel M. Seiça

  3. Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, Polo III, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548, Coimbra, Portugal

    Teresa M. Louro, Paulo N. Matafome & Raquel M. Seiça

  4. Department of Surgery A, University Hospital of Coimbra, Rua Fonseca Pinto, 3000-075, Coimbra, Portugal

    Francisco Castro e Sousa

  5. Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal

    Francisco Castro e Sousa

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  1. Hans Eickhoff
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Correspondence to Hans Eickhoff.

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All research was done at the Laboratory for Experimental Research, the Institute of Physiology, and the Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

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Eickhoff, H., Louro, T.M., Matafome, P.N. et al. Amelioration of Glycemic Control by Sleeve Gastrectomy and Gastric Bypass in a Lean Animal Model of Type 2 Diabetes: Restoration of Gut Hormone Profile. OBES SURG 25, 7–18 (2015). https://doi.org/10.1007/s11695-014-1309-8

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