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Proximal small intestinal bypass outperforms Roux-en-Y and jejunoileal bypass in glucose regulation in streptozotocin induced diabetic rats
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作者 Chi-Ying Xu Cai Tan +5 位作者 Xin Luo Kun Yang ren-ran wu Lei Lin Guan-Lei Liu Jin-Yuan Duan 《World Journal of Gastrointestinal Surgery》 2025年第2期237-246,共10页
BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their gly... BACKGROUND The efficacy of various bariatric surgeries varies in reducing blood glucose levels.Given the distinct mechanisms and anatomical alterations associated with each procedure,it is crucial to compare their glycemic control outcomes.We hypothesize that proximal small intestinal bypass(PSIB)is superior in blood glucose reduction over Roux-en-Y gastric bypass(RYGB)and jejunoileal bypass(JIB).AIM To compare the effectiveness of PSIB,RYGB,and JIB in lowering blood glucose.METHODS Rats with streptozotocin-induced diabetes were randomly divided into PSIB,RYGB,JIB,and sham-operated groups.Body weight,food intake,fasting blood glucose level,oral glucose tolerance test,insulin tolerance test,liver enzymes,and blood lipids were measured.RESULTS Postoperatively,only the JIB group had a lower body weight compared to the sham group.The food intake of the rats in all three surgical groups was significantly less than that in the sham group.Fasting blood glucose was reduced in all surgical groups and was lower in the PSIB group than in the RYGB and JIB groups.Glucose tolerance and insulin sensitivity improved in all three surgical groups compared to the sham group,but the improvement appeared earliest in the PSIB group.At six weeks postsurgery,the PSIB group showed a reduction in alanine transaminase levels and maintained a normal lipid profile.CONCLUSION PSIB demonstrated excellent hypoglycemic effects in the early postoperative period,and had better efficacy than RYGB and JIB. 展开更多
关键词 Bariatric surgery DIABETES Glucose control Proximal small intestinal bypass Roux-en-Y gastric bypass Jejunoileal bypass
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Distal small bowel resection with preservation of the terminal ileum suppresses hepatic gluconeogenesis via the Prevotellaceae_NK3B31_group-mediated 7-KLCA-FXR axis
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作者 Chi-Ying Xu Zhi-Hua Zheng +3 位作者 Kun Yang ren-ran wu Jia-Qing Cao Jin-Yuan Duan 《World Journal of Gastroenterology》 2025年第43期135-145,共11页
BACKGROUND Distal small bowel resection with preservation of the terminal ileum(DBRPI)significantly improves glucose metabolism in rats.AIM To explore the underlying mechanisms of DBRPI in improving glucose metabolism... BACKGROUND Distal small bowel resection with preservation of the terminal ileum(DBRPI)significantly improves glucose metabolism in rats.AIM To explore the underlying mechanisms of DBRPI in improving glucose metabolism.METHODS Following 8 weeks of a high-fat diet,the rats were randomly divided into the DBRPI group and the sham operation group.After surgery,body weight and glucose tolerance were monitored.At 6 weeks post-surgery,the composition of intestinal microbiota,bile acid levels,and the expression of farnesoid X receptor(FXR),Takeda G protein-coupled receptor 5,and glucagon-like peptide-1(GLP-1)in the ileum were examined.Additionally,the gene expression of key enzymes involved in gluconeogenesis in the liver was evaluated.RESULTS DBRPI reduced body weight and improved glucose tolerance.At 6 weeks postsurgery,the abundance of Prevotellaceae_NK3B31_group and the level of 7-ketolithocholic acid(7-KLCA)were significantly increased,while the abundance of Desulfovibrio fairfieldensis and the level ofα-muricholic acid were significantly decreased.The expression of FXR and GLP-1 in the terminal ileum was significantly upregulated.Furthermore,the expression of key gluconeogenic enzyme genes,glucose-6-phosphatase(G6PC)and phosphoenolpyruvate carboxykinase 1(PCK1),was significantly downregulated.Correlation analysis showed that the Prevotellaceae_NK3B31_group was positively correlated with 7-KLCA and FXR,and negatively correlated with glucose tolerance,α-muricholic acid,G6PC,and PCK1.CONCLUSION DBRPI inhibits hepatic gluconeogenesis and improves glucose metabolism.The mechanism may be related to activation of the 7-KLCA-FXR signaling pathway mediated by the Prevotellaceae_NK3B31_group. 展开更多
关键词 Bariatric surgery Mid to distal bowel resection Gut microbiota Bile acids GLUCONEOGENESIS
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