Abstract: Objective：To investigate the effects of ileal transposition on the levels of glycemia and intestinal hormones in a porcine model.
Methods：Nineteen Yorkshire young pigs were randomly divided into ileal transposition group (10 pigs) and sham operation group (9 pigs). The body weights of the pigs were recorded before operation and on postoperative week 1, 2, 3 and 4, and the routine biochemical indicators such as white blood 〖HJ*4〗cell (WBC), red blood cell (RBC), hematocrit (HCT), hemoglobin (Hb) were determined before operation and on postoperative week 2 and 4. Duodenum glucose tolerance test (DGTT) was performed before operation and on postoperative week 4. Blood samples at different time points were collected for glucose measurement, and the area under curve (AUC) was calculated. The levels of glucagon like peptide 〖KG*9〗1 (GLP 〖KG*9〗1) were detected at 0 minute and 40 minutes in the DGTT. All data were analyzed using the Mann Whitney U non parametric test.
Results The body weights of the pigs on postoperative week 1, 2, 3 and 4 were 29.5 kg, 30.3 kg, 31.6 kg, 32.1 kg in the ileal transposition group, and 26.1 kg, 28.9 kg, 30.5 kg, 34.1 kg in the sham operation group. The body weights at postoperative week 2, 3, 4 were significantly higher than those at postoperative week 1 in the 2 groups ( Z ileal transposition group = 2.11, 2.21, 2.33, Z sham operation group =2.13, 2.18, 2.27, P <0.05). There was no significant difference in the body weights in postoperative week 4 between the 2 groups ( Z=0.45, P >0.05). The levels of WBC, RBC, HCT, Hb were (19.9±3.2)×10 9/L, (5.40±0.21)×10 12 /L, (29.8±1.4)×10 9/L, (84±4)g/L at postoperative week 2, and (23.3±2.5)×10 9/L, (5.30±0.22)×10 12 /L, (30.1±1.6)×10 9/L, (85±4)g/L at postoperative week 4, and (16.7±1.6)×10 9/L, (5.80±0.22)×10 12 /L, (33.1± 1.3) ×10 9/L, (92±4)g/L before operation in the ileal transposition group. There were no significant differences in the 4 indexes before and after operation ( Z WBC =1.24, 1.54, Z RBC =0.84, 0.88, Z HCT =0.95, 0.83, Z Hb =1.25, 1.17, P >0.05). The levels of WBC, RBC, HCT, Hb were (18.7±2.3)×10 9/L, (5.50±0.21)×10 12 /L, (33.3±1.1)×10 9/L, (89±4)g/L at postoperative week 2, and (16.2±0.7)×10 9/L, (5.60± 0.16) ×10 12 /L, (34.5±1.6)×10 9/L, (89±4)g/L at postoperative week 4, there were no significant differences in the 4 indexes before and after operation ( Z WBC = 1.04, 0.36, Z RBC =0.78, 0.43, Z HCT =0.22, 0.42, Z Hb =0.78, 0.79, P >0.05). The peak level of glycemia of the ileal transposition group was (10.6±2.9)mmol/L, which was significantly lower than (13.5±2.6)mmol/L before operation and (13.3±3.7)mmol/L of the sham operation group ( Z=2.31, 2.30, P <0.05). The glycemic peak time of the ileal transposition group was (90±11)minutes, which was significantly delayed when compared with (50±5)minutes of the sham operation group ( Z=2.29, P <0.05). The AUC of the ileal transposition group was (1569±546)mmol/L×minutes, which were significantly lower than (1938±873)mmol/L×minutes ( Z=2.26, P <0.05). At postoperative week 4, the GLP 〖KG*9〗1 level of the ileal transposition group was (10.0±1.6)μg/L, which was significantly higher than (4.3± 1.7)μg/L at 40 minutes after glucose administration ( Z=2.12, P <0.05).
Conclusion：Ileal transposition could effectively improve the glycemia metabolism and elevate the level of intestinal hormone GLP 〖KG*9〗1 in large mammals, meanwhile, Ileal transposition itself will not lead to body weight loss.