Abstract
Type 2 diabetes mellitus (T2DM) is a prevalent disease worldwide and during its conventional treatment, vascular complications remain unavoidable. Roux-en-Y gastric bypass (GBP) is able to induce the remission of T2DM. However, studies of duodenal-jejunal bypass (DJB), a modified procedure of GBP, are being carried out to investigate its ability to induce the remission of T2DM and protect the aorta from atherosclerosis. The present study aimed to investigate the effect of DJB on the rate of T2DM remission and the prevention of atherosclerosis in the aorta in rats with streptozotocin-induced diabetes without obesity, and to explore the mechanism of DJB in protecting the aorta from atherosclerosis. A T2DM rat model was established with a high-fat diet and low-dose streptozotocin. Surgery was performed to analyze its effects on glucose homeostasis, lipid metabolism, inflammation and pathological changes. Furthermore, changes in c-jun NH2-terminal kinase 1 (JNK1) and inhibitor of κB kinase (IKKβ) genes in the aorta following DJB surgery were examined. Levels of blood glucose, lipids, insulin and tumor necrosis factor (TNF)-α were significantly elevated in the T2DM diabetic model compared with the non-diabetic control. A gradual recovery was observed in the DJB group following surgery. Foam cells and atherosclerotic plaques appeared in the ascending aortic tissue in the sham-surgery and T2DM groups, whereas only slight lesions were observed in the DJB group. The expression levels of JNK1 and IKKβ genes in the aorta were significantly increased in the sham-operated and T2DM groups compared with those in the DJB and normal control groups. The present study demonstrated that DJB caused remission of T2DM without weight loss in non-obese rats. Thus, DJB may delay or prevent the occurrence and development of atherosclerosis in the aorta and this may occur through the JNK1 and nuclear factor κB (NF-κB) signaling pathways.
Highlights
Type 2 diabetes mellitus (T2DM), which is an endocrine and metabolic disease, has become the third most common type of non‐infectious disease worldwide following cardiovascular disease and cancer [1]
gastric bypass (GBP) may primarily contribute to the reduction of blood glucose levels in patients with T2DM rather than the control of weight [22,23,24]
In severely obese patients with T2DM, GBP surgery has been shown to result in improved glucose control compared with that achieved by medical therapy [25]
Summary
Type 2 diabetes mellitus (T2DM), which is an endocrine and metabolic disease, has become the third most common type of non‐infectious disease worldwide following cardiovascular disease and cancer [1]. Conventional treatment of T2DM tends to lead to various complications. Previous studies investigating obesity treatments have demonstrated that Roux‐en‐Y gastric bypass (GBP) is able to induce the remission of T2DM [2,3,4], and a further study revealed that GBP is able to treat T2DM patients with obesity, and to prevent the occurrence of complications [5,6,7]. Whether GBP exhibits the same effect in non‐obese patients with T2DM remains unclear. Studies investigating the effects of GBP in non‐obese patients with T2DM are limited. Studies investigating the effects of GBP in T2DM patients with a BMI
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