Abstract: Objective:To investigate the regulatory effects of sleeve gastrectomy on the glucose and lipid metabolism in rats with type 2 diabetes mellitus.
Methods:Twentyfour GotoKakizaki rats aged 11 weeks were randomly divided into the blank group (the rats did not receive any surgical procedures), sham operation group (the rats received abdominal incision and suture at the same site as the rats in the operation group) and operation group (the rats received sleeve gastrectomy). There were 8 rats in each group. The changes of the body weight, food intake, glucose and lipid metabolism and gastrointestinal hormones were measured at different time points after operation. All data were analyzed using the analysis of variance or LSD test.
Results:In postoperative week 6, the body weights and food intake were decreased to (320±12)g and (25.1±0.8)g in the blank group, (318±12)g and (25.5±1.3)g in the sham operation group, (299±9)g and (21.9±1.3)g in the operation group. There were significant differences in the body weight and food intake between the 3 groups (F=8.50, 10.02, P< 0.05). In postoperative week 16, the levels of fasting glucose, the areas under the curve of the oral glucose tolerance test and insulin tolerance test, index of insulin resistance, ghrelin, free fatty acides and leptin were (11.4±1.1)mmol/L, (3 220±460) mmol/L·min-1, (2 317±715)mmol/L·min-1, 4.2±0.4, (1 513±75)ng/L, (2.16±0.20)μg/L, (6.2±0.8)μg/L in the blank group, (12.9±1.3)mmol/L, (3 554±272)mmol/L·min-1, (2 078±367)mmol/L·min-1, 4.2±0.8, (1 510±72)ng/L, (1.95±0.31)μg/L, (6.3±0.7)μg/L in the sham operation group, (5.5±0.3)mmol/L, (2 077±221)mmol/L·min-1, (946±330)mmol/L·min-1, 2.2±0.5, (986±75)ng/L, (1.44±0.13)μg/L and (2.5±0.7)μg/L in the operation group. There were significant differences in the fasting glucose, the areas under the curve of the oral glucose tolerance test and insulin tolerance test, index of insulin resistance, ghreliln, free fatty acides and leptin between the 3 groups (F=84.19, 7.33, 9.93, 18.81, 99.79, 79.02, 238.30, P<0.05). The levels of higher glucagonlike peptide-1 (GLP-1), peptide YY, insulin, adiponectin were (11.3±2.3)pmol/L, (70±13)ng/L, (7.8±1.0)mIU/L, (4.9±1.2)μg/L in the blank group, (11.2±1.7)pmol/L, (72±14)ng/L, (9.9±1.9)mIU/L and (5.0±0.9)μg/L in the sham operation group, (14.7±2.4)pmol/L, (128±20)ng/L, (21.7±2.1)mIU/L, (7.8±1.1)μg/L in the operation group at 60 minutes after glucose gavage at postoperative week 16. There were significant difference in the levels of GLP-1, peptide YY, insulin, adiponectin between the 3 groups (F=4.22, 20.91, 89.17, 27.24, P<0.05).
Conclusion:Sleeve gastrectomy could significantly improve the glucose and lipid metabolic disorder. The mechanism may be related with elevated GLP1, peptide YY and adiponectin levels and decreased ghrelin, free fatty acides and leptin levels.