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Sub-sleeve gastrectomy achieves good diabetes control without weight loss in a non-obese diabetic rat model

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Abstract

Background

Although weight loss has been implicated in anti-diabetic effects, sleeve gastrectomy (SG)-mediated anti-diabetic effects are induced through mechanisms beyond weight loss. Our aim was to investigate whether anti-diabetic effects can be achieved by surgically removing a smaller portion of the stomach instead of SG.

Methods

Male 11-week-old Goto–Kakizaki rats (N = 50) were randomized into five groups: sub-sleeve gastrectomy (SSG, only the gastric fundus is removed), SG, sham-operated SSG, sham-operated SG, and control. Body weight, food intake, hormone secretion, and glucose metabolism were measured up to 24 weeks after surgery.

Results

The data showed that (i) both SSG and SG surgeries significantly improved glucose homeostasis, with lower ghrelin levels and higher post-prandial glucagon-like peptide 1, peptide YY, and insulin levels; (ii) SG, but not SSG, produced sustained weight loss and significant reduction of food intake; and (iii) SG induced better long-term diabetic improvement than SSG.

Conclusions

The SSG that only removed the gastric fundus exhibited significant diabetic improvement without weight loss, but did not induce long-term diabetic improvement comparable to that of SG. Our study helps to understand the role of hormones and weight loss in maintaining long-term diabetes improvement after SG.

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (No. 81270888/H0713, No. 81070642/H0713, No. 81370496/H0308, No. 81300286/H0308), Specialized Research Fund for the Doctoral Program of Higher Education (No. 20100131110049), Shandong Provincial Outstanding Medical Academic Professional Program, Natural Science Foundation of Shandong Province Grants (No. ZR2012HQ030), and Graduate Independent Innovation Foundation of Shandong University (No. yzc11068).

Disclosures

Dong Sun, Shaozhuang Liu, Guangyong Zhang, Punsiri Colonne, Chunxiao Hu, Haifeng Han, Mingxia Li and Sanyuan Hu declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People’s Republic of China

    Dong Sun, Shaozhuang Liu, Guangyong Zhang, Chunxiao Hu, Haifeng Han & Sanyuan Hu

  2. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, 60612, USA

    Punsiri Colonne

  3. Experimental Center, School of Chemistry and Chemical Engineering of Shandong University, Jinan, 250100, Shandong, People’s Republic of China

    Mingxia Li

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  1. Dong Sun
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Correspondence to Sanyuan Hu.

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Dong Sun, Shaozhuang Liu, and Guangyong Zhang have contributed equally to this work.

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Sun, D., Liu, S., Zhang, G. et al. Sub-sleeve gastrectomy achieves good diabetes control without weight loss in a non-obese diabetic rat model. Surg Endosc 28, 1010–1018 (2014). https://doi.org/10.1007/s00464-013-3272-1

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