Gastrectomy In Rats Research Articles

Effect of Oral Skim Milk Administration on Skeletal Muscle Protein Synthesis after Total Gastrectomy in Rat.

Leucine is a branched-chain amino acid that is present in protein, and it is an essential factor in activating the mechanistic target of the rapamycin complex 1 signaling pathway and increasing muscle protein synthesis. However, the loss of digestive function after total gastrectomy leads to impaired protein absorption, potentially failing to stimulate muscle protein synthesis. Therefore, this study aimed to investigate whether muscle protein synthesis is enhanced by oral skim milk administration after total gastrectomy. Male Sprague Dawley rats were divided into total gastrectomy (TG) and sham surgery (S) groups. After five weeks postoperatively, we orally administered skim milk to achieve 3.1 g protein/kg body weight and collected blood and gastrocnemius muscle. The gastrocnemius muscle weight was significantly lower in the TG group than in the S group (p < 0.05). The increase in plasma leucine concentration was significantly lower in the TG group than in the S group (p < 0.05). The skeletal muscle protein synthesis and the phosphorylation of p70S6K and 4E-BP1 showed a similar increase in both groups. Even after TG, muscle protein synthesis was stimulated by consuming skim milk, accompanied by a sufficient rise in plasma leucine concentration.

The effects of vitamin B6 on the nutritional support of BCAAs-enriched amino acids formula in rats with partial gastrectomy

Total parenteral nutrition with the formula of amino acids enriched branched-chain amino acids (BCAAs) could promote patients' recovery after gastrointestinal surgery. Previous studies reported that vitamin B6 could promote amino acid metabolism and enhance protein synthesis. The aim of this study was to determine if the addition of vitamin B6 to BCAAs-enriched formula can enhance postoperative nutritional status and intestinal function in rats undergoing partial gastrectomy, and the appropriate compatibility concentration of vitamin B6. Fifty-six male rats were randomly divided into seven groups (n=8 per group): (I) Control, (II) BCAAs-enriched formula group (BCAA), (III) BCAA plus vitamin B6 (50mg/L), (IV) BCAA plus vitamin B6 (100mg/L), (V) BCAA plus vitamin B6 (200mg/L), (VI) BCAA plus vitamin B6 (500mg/L), and (VII) BCAA plus vitamin B6 (1000mg/L). All animals were performed partial gastrectomy and placed a jugular vein catheter. During enteral nutrition, blood and urine samples were repeatedly collected. Gastrocnemius muscle and small intestine were also collected at the end of experiment. The addition of vitamin B6 to BCAAs-enriched formula improved negative nitrogen balance after gastrectomy compared to the BCAAs-enriched formula group at POD1 (first postoperative day) and POD3 (third postoperative day), and 100mg/L was an appropriate concentration of vitamin B6 to enhance the effects of BCAAs-enriched formula. The 3-methylhistidine/creatinine in BCAA plus vitamin B6 groups were significantly lower than that in the BCAA group at POD3. Moreover, BCAA plus vitamin B6 group significantly increased the cross-sectional area of the muscle fibers compared to the BCAA group. Transcriptome sequencing, GO and KEGG enhancement analysis also showed that BCAA plus vitamin B6 group showed muscle organ development and PI3K/AKT pathway enhancement compared to BCAA group. Moreover, AKT/mTOR/4EBP1 pathway was activated in BCAA plus vitamin B6 group. In addition, the results also showed that BCAA plus vitamin B6 decreased D-lactate, and exerted synergistic effects on intestinal morphology. The addition of vitamin B6 to BCAAs-enriched formula could improve nitrogen balance, promote muscle protein synthesis through AKT/mTOR/4EBP1 pathway, and alleviate intestinal mucosa damage after partial gastrectomy in rats. Overall, the results from this pre-clinical study support the use of vitamin B6 as an ingredient to BCAAs-enriched formula, and 100mg/L may be an optimal concentration for rats.

Calycosin Improves Intestinal Mucosal Barrier Function after Gastrectomy in Rats through Alleviating Bacterial Translocation, Inflammation, and Oxidative Stress.

Objective Calycosin is the main bioactive extract of Astragali Radix with anti-inflammation, antioxidant, and anticancer properties. Here, our study evaluated the protective effects and mechanisms of calycosin on intestinal mucosal barrier under gastrectomy. Methods After receiving gastrectomy, the rats were administrated with 20 mg/kg, 40 mg/kg, or 80 mg/kg calycosin. Endotoxin, bacterial translocation, and intestinal bacterial flora were assayed. Intestinal injury was detected via hematoxylin and eosin staining. Tight junction indicators (occludin, claudin, and ZO-1) and apoptotic proteins (Bax, Bcl-2, and cleaved caspase 3) were examined in intestinal tissues. Inflammatory indicators (IL-1β, IL-6, and TNF-α) were examined in serum or intestinal specimens via ELISA. Apoptosis was assessed via TUNEL staining. IgA + B cells in intestinal tissues and sIgA in intestinal lumen were examined through immunohistochemistry and ELISA, respectively. Oxidative stress indicators (TSH, SOD, CAT, GSH-Px, and MDA) were also detected via ELISA. Results Our results showed that calycosin administration decreased endotoxin levels in peripheral blood, intestine, and portal vein blood; lowered the bacterial translocation ratio; and regained the balance among intestinal bacterial flora (comprising bifidobacterium, lactic acid bacillus, enterobacter, enterococcus, aerobic bacteria, and anaerobic bacteria) in the rats with gastrectomy. After calycosin treatment, intestinal mucosal damage of the rats with gastrectomy was ameliorated, with the increase in expression of tight junction proteins. Additionally, calycosin reduced intestinal inflammation, apoptosis, secretion of sIgA, and oxidative stress in the rats with gastrectomy. Conclusion Altogether, our findings demonstrate that calycosin may improve intestinal mucosal barrier function under gastrectomy via reducing bacterial translocation, inflammation, and oxidative stress.

Colonic Lymphoid Follicle Hyperplasia after Gastrectomy in Rats.

Nodular lymphoid hyperplasia (NLH) of the human colon has been associated with multiple diseases and symptoms. Causes include food allergies, infections, inflammatory bowel disease, and immunodeficiency, and gastrectomy is not usually considered to be the etiology. Nine rats two weeks after total gastrectomy and 12 control rats were sacrificed and submitted for histological examination. In the gastrectomy group, we found lymphoid hyperplasia throughout the entire colon mucosa. The cross-sectional area of lymphoid follicles was increased to be five-fold larger than that in the rats in the control group (sham surgery). Lymphoid follicles were classified into primary and secondary follicles according to the presence/absence of germinal centers; the gastrectomy group had a significantly larger number of secondary follicles. When T cell and B cell classification of lymphocytes was performed, there was no difference between gastrectomy and control groups at T:B = 40:60. When the lymphoid follicles were classified, the proportion of T lymphocytes increased in the secondary follicle (T:B = 40:60) compared with in the primary follicle (T:B = 20:80). Gastrectomy significantly activated lymphocytic intestinal immunity by altering the intestinal environment, causing colonic NLH. Gastrectomy in rats is a good animal model for the study of NLH in colorectal diseases.

The Effectiveness of Long-term Use of Low-Molecular-Weight Heparin on Venous Thromboembolism After Sleeve Gastrectomy in Rats

Objectives: The aim of the study was to investigate the effects of bemiparin administration for 15 and 30 days on deep vein thrombosis (DVT) in high-fat diet-induced rats, followed by sleeve gastrectomy (SG) for DVT prophylaxis. Setting: The study was conducted at the Kobay Experimental Animals Laboratory. Materials and Methods: Forty rats were fed a high-fat diet to induce obesity. They were then equally divided into four groups (n = 10); group 1 (control group); group 2 (nonbemiparin group); and group 3 (15-day bemiparin group) and group 4 (30-day bemiparin group) in which bemiparin therapeutic doses were administered for 15 and 30 days, respectively. Sixteen weeks after feeding, SG was performed on rats from groups 2, 3, and 4. Doppler ultrasonography was performed to investigate thrombosis of the inferior vena cava and iliac veins in all rats before and 1 month after SG. Rat vena cava, iliac veins, and lung tissues were removed to determine venous thrombosis status and investigate microthrombi through histological examination. Results: No statistically significant difference was found between groups in terms of the thickness of intima–media (μm), thrombus area (μm2), and erythrocyte, leukocyte, and platelet/fibrin values of the iliac veins (p > 0.05). A statistically significant difference was found between groups in terms of the presence of thrombus and radiological status of the vena cava (p < 0.05). In addition, the measurement percentage was found to be 100% in group 2, 37.5% in group 3, and 12.5% in group 4. Conclusion: We believe that administration of bemiparin once a day for 30 days can be a safe and effective treatment method in the prevention of microthrombi, following SG.

Ameliorating Effects and Mechanisms of Intra-Operative Vagal Nerve Stimulation on Postoperative Recovery After Sleeve Gastrectomy in Rats.

Sleeve gastrectomy is a common bariatric procedure. The aim of this study was to explore the effects and mechanisms of intra-operative vagal nerve stimulation (iVNS) on postoperative recovery after sleeve gastrectomy in rats. Rats were randomly divided into groups of sham-iVNS (n = 12) and iVNS (n = 12), and received sleeve gastrectomy, and were implanted electrodes for the electrocardiogram (ECG) and gastric pace-making activity or slow wave (GSW). iVNS or sham-iVNS was performed during surgery. Postoperative animal behaviors, pain, gastrointestinal functions, autonomic functions, inflammatory cytokines, and hormones in plasma were assessed. In comparison with sham-iVNS, (1) iVNS accelerated the first drinking time (P = 0.01) and first defecation time (P = 0.02), increased the weight of stool in postoperative day (POD) 1 (P = 0.01) and POD3 (P = 0.01), and reduced postoperative pain at 24h after surgery (P = 0.01); (2) physiologically, iVNS improved gastric emptying (P < 0.01) at 72h after surgery, and increased the dominant frequency (P < 0.01) and the percentage of normal GSW (P = 0.04) at 6h after surgery; (3) mechanistically, iVNS increased vagal activity and decreased sympathovagal ratio at 6h (vagal, P < 0.01; sympathovagal ratio, P < 0.01) and 24h (vagal, P = 0.02; sympathovagal ratio, P = 0.01) after surgery, increased the plasma pancreatic polypeptide (P = 0.03) at 1h after surgery, and decreased the plasma tumor necrosis factor-α (TNF-α) at 1h (P = 0.02) and 6h (P = 0.03) and the plasma interleukin-6 (IL-6) at 1h (P = 0.02) after surgery. Intra-operative VNS is effective in accelerating post-surgical recovery in rats after sleeve gastrectomy by enhancing gastric pace-making activity and suppressing proinflammatory cytokines mediated via the autonomic mechanisms.

Continuous glucose monitoring reveals glycemic variability and hypoglycemia after vertical sleeve gastrectomy in rats

ObjectivePost–bariatric surgery hypoglycemia (PBH) is defined as the presence of neuroglycopenic symptoms accompanied by postprandial hypoglycemia in bariatric surgery patients. Recent clinical studies using continuous glucose monitoring (CGM) technology revealed that PBH is more frequently observed in vertical sleeve gastrectomy (VSG) patients than previously recognized. PBH cannot be alleviated by current medication. Therefore, a model system to investigate the mechanism and treatment is required. MethodsWe used CGM in a rat model of VSG and monitored the occurrence of glycemic variability and hypoglycemia in various meal conditions for 4 weeks after surgery. Another cohort of VSG rats with CGM was used to investigate whether the blockade of glucagon-like peptide-1 receptor (GLP-1R) signaling alleviates these symptoms. A mouse VSG model was used to investigate whether the impaired glucose counterregulatory system causes postprandial hypoglycemia. ResultsLike in humans, rats have increased glycemic variability and hypoglycemia after VSG. Postprandial hypoglycemia was specifically detected after liquid versus solid meals. Further, the blockade of GLP-1R signaling raises the glucose nadir but does not affect glycemic variability. ConclusionsRat bariatric surgery duplicates many features of human post–bariatric surgery hypoglycemia including postprandial hypoglycemia and glycemic variability, while blockade of GLP-1R signaling prevents hypoglycemia but not the variability.

Tu1924 – Ameliorating Effects and Mechanisms of Intra-Operative Vagal Nerve Stimulation on Postopearive Recovery After Sleeve Gastrectomy in Rats

Tu1924 – Ameliorating Effects and Mechanisms of Intra-Operative Vagal Nerve Stimulation on Postopearive Recovery After Sleeve Gastrectomy in Rats

Metabolic comparison of one-anastomosis gastric bypass, single-anastomosis duodenal-switch, Roux-en-Y gastric bypass, and vertical sleeve gastrectomy in rat

BackgroundOne-anastomosis gastric bypass (OAGB) and single-anastomosis duodenal switch (SADS) have become increasingly popular weight loss strategies. However, data directly comparing the effectiveness of these procedures with Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (SG) are limited. ObjectivesTo examine the metabolic outcomes of OAGB, SADS, RYGB, and SG in a controlled rodent model. SettingAcademic research laboratory, United States. MethodsSurgeries were performed in diet-induced obese Long-Evans rats, and metabolic outcomes were monitored before and for 15 weeks after surgery. ResultsAll bariatric procedures induced weight loss compared with sham that lasted throughout the course of the study. The highest percent fat loss occurred after OAGB and RYGB. All bariatric procedures had improved glucose dynamics associated with an increase in insulin (notably OAGB and SADS) and/or glucagon-like protein-1 secretion. Circulating cholesterol was reduced in OAGB, SG, and RYGB. OAGB and SG additionally decreased circulating triglycerides. Liver triglycerides were most profoundly reduced after OAGB and RYGB. Circulating iron levels were decreased in all surgical groups, associated with a decreased hematocrit value and increased reticulocyte count. The fecal microbiome communities of OAGB, SADS, and RYGB were significantly altered; however, SG exhibited no change in microbiome diversity or composition. ConclusionsThese data support the use of the rat for modeling bariatric surgical procedures and highlight the ability of the OAGB to meet or exceed the metabolic improvements of RYGB. These data point to the likelihood that each surgery accomplishes metabolic improvements through both overlapping and distinct mechanisms and warrants further research.

Effect of Acellular Amniotic Membrane Matrix Patch on Healing of Cut Surface After Sleeve Gastrectomy in Rats

ABSTRACTBackground: The aim of this study was to evaluate the effect of acellular amniotic membrane matrix patch on healing cut surface after sleeve gastrectomy in rats. Methods: Thirty male Wistar albino rats were divided into three groups: control (n = 10), Experiment-1 (n = 10), and Experiment-2 (n = 10) groups. Control group rats underwent only sleeve gastrectomy with primary gastrorrhaphy. Experiment-1 group rats underwent sleeve gastrectomy, primary gastrorrhaphy and covered with acellular amniotic membrane matrix patch. Experiment-2 group rats underwent sleeve gastrectomy, incomplete primary gastrorrhaphy and covered with acellular amniotic membrane matrix patch. All rats were sacrificed on the fifth postoperative day. Macroscopic findings and histopathologic alterations were evaluated and compared. Results: There was a statistically significant difference between levels of PMNs, granulation formation and vascularization, distributions of edema, type of mucosal epithelium, and fibroblastic proliferation according to groups (p < 0.05). The PMNs level in the Experiment-1 group was significantly lower than the control group (p < 0.05). In experiment groups, the level of granulation tissue, vascularization and fibroblastic proliferation was significantly higher than the control group (p < 0.05). The levels of edema and type of mucosal epithelium of the experiment groups were significantly lower than the control group (p < 0.05). Conclusion: Covering sleeve gastrectomy cut surface area with acellular amniotic membrane matrix results better healing. Moreover, acellular amniotic membrane matrix provides safe healing even in incomplete sutured area.

Effects of thyroid hormone supplementation on oxidative stress after sleeve gastrectomy in rats

Aim: Sleeve gastrectomy has been used for the surgical treatment of morbid obesity. The aim of the present study was to determine the effects of triiodothyronine supplementation on oxidative stress parameters in anastomotic tissue level. Material and Methods: Twenty-four male Wistar albino rats were divided into control (n:12), and experimental (n:12) groups and underwent sleeve gastrectomy. Experimental group rats received a single dose of triiodothyronine (400 mg/100 g) in the operation day. Rats were sacrificed on postoperative day 7. Serum thyroid hormones were analysed. The supernatants were used to measure total oxidant status, total antioxidant status, nitric oxide and malondialdehyde levels. All tissue parameters were analysed by spectrophotometric methods. Oxidative stress index values were calculated. Results: Thyroid stimulating hormone levels in both the control and triiodothyronine group did not significantly change on the 7th postoperative day (p=0.663). Free triiodothyronine levels were significantly higher in triiodothyronine group rats than in control group rats (triiodothyronine vs control: p=0.004). Although total oxidant status levels did not altered by thyroid hormone treatment (p>0.05), total antioxidant status levels significantly decreased (p0.05). Tissue nitric oxide levels were also similar in both groups (p>0.05). Malondialdehyde levels increased in triiodothyronine given rats compared with the control group (p

The effect of hypergastrinemia following sleeve gastrectomy and pantoprazole on type 2 diabetes mellitus and beta-cell mass in Goto-Kakizaki rats.

Metabolic surgery alters the secretion of gastrointestinal hormones that influence glycemic control. Elevated gastrin has been suggested to benefit patients with type 2 diabetes and has been reported following sleeve gastrectomy in rats. The present study compares the effect of hypergastrinemia following sleeve gastrectomy with proton-pump inhibitor therapy on glycemic control and beta-cell mass in lean, diabetic animals. Thirty-three diabetic Goto-Kakizaki rats were randomized into pantoprazole+sham operation (GK-PPI), sleeve gastrectomy (GK-SG) and vehicle+sham operation (GK-V). Body weight, glucose parameters, HbA1c, glucagon-like peptide 1, gastrin, insulin and lipids were evaluated for eighteen postoperative weeks. Total beta-cell mass was quantified by optical projection tomography. After surgery, body weight development was equal among groups (P g=0.75). Fasting and stimulated gastrin increased for GK-PPI and GK-SG vs. GK-V (p<0.05 for all). Fasting blood glucose was decreased for GK-PPI and GK-SG vs. GK-V (p<0.05 and p=0.052). HbA1c was lower for GK-SG vs. GK-V at 6weeks and for GK-PPI vs. GK-V at twelve- and eighteen weeks postoperative (p<0.05 for all); a borderline difference was observed for GK-SG vs. GK-V at 18weeks (p=0.054). Total- and LDL cholesterol was elevated for GK-PPI compared to the other two groups (p<0.05 for all). Beta-cell mass did not differ among groups (p=0.35). Hypergastrinemia following sleeve gastrectomy and pantoprazole has a similar, modest effect on glycemic control in Goto-Kakizaki rats but does not enhance beta-cell mass after 18weeks. Hypergastrinemia in the setting of T2DM might be of clinical relevance.

A5088 - One- vs. Two-staple Line Vertical Sleeve Gastrectomy in Rats: Does it Matter?

A5088 - One- vs. Two-staple Line Vertical Sleeve Gastrectomy in Rats: Does it Matter?

Insulin Resistance, Microbiota, and Fat Distribution Changes by a New Model of Vertical Sleeve Gastrectomy in Obese Rats

Metabolic surgery improves insulin resistance and type 2 diabetes possibly because of weight loss. We performed a novel sleeve gastrectomy in rats that resects ∼80% of the glandular portion, leaving the forestomach almost intact (glandular gastrectomy [GG]) and compared subsequent metabolic remodeling with a sham operation. GG did not affect body weight, at least after 10 weeks; improved hepatic and peripheral insulin sensitivity likely through increased Akt, glycogen synthase kinase 3, and AMPK phosphorylation; and reduced ectopic fat deposition and hepatic glycogen overaccumulation. Body adipose tissue was redistributed, with reduction of intraabdominal fat. We found a reduction of circulating ghrelin levels, increased GLP-1 plasma concentration, and remodeling of gut microbiome diversity characterized by a lower relative abundance of Ruminococcus and a higher relative abundance of Lactobacillus and Collinsella These data suggest that at least in rat, the glandular stomach plays a central role in the improvement of insulin resistance, even if obesity persists. GG provides a new model of the metabolically healthy obese phenotype.

Total gastrectomy-induced reductions in food intake and weight are counteracted by rikkunshito by attenuating glucagon-like peptide-1 elevation in rats

Decrease in appetite and weight after total gastrectomy in patients with gastric cancer leads to a decrease in quality of life, increased mortality, and may necessitate discontinuation of adjuvant chemotherapy. The aim of this study is to determine whether rikkunshito, a Japanese herbal medicine, increases food intake and weight after gastrectomy in rats. Male rats underwent gastrectomy followed by roux-en-Y reconstruction or sham operation and were then treated with rikkunshito for 14 days starting on postoperative day 3. Daily food intake, weight, plasma glucagon-like peptide-1 (GLP-1), and ghrelin levels were measured. A pilot study to measure pre- and postoperative plasma GLP-1 levels was conducted in patients who underwent total gastrectomy for gastric cancer. Administration of rikkunshito after gastrectomy in rats significantly increased food intake and weight, which continued for at least 2 weeks after treatment. Both fasting and postprandial plasma GLP-1 levels were increased markedly after gastrectomy compared with sham-operated animals. Increased GLP-1 levels in rats after gastrectomy were suppressed markedly by rikkunshito. rikkunshito had no significant effect on plasma ghrelin levels after gastrectomy. Treatment with a GLP-1 receptor antagonist significantly improved food intake and weight after gastrectomy. Plasma fasting GLP-1 levels in patients with gastric cancer were increased greatly after gastrectomy on postoperative day 1. Administration of rikkunshito suppresses plasma GLP-1 levels after total gastrectomy, which is associated with recovery from reduced food intake and weight in rats.

Alternate current biosusceptometry for the assessment of gastric motility after proximal gastrectomy in rats: afeasibility study.

This study proposes an experimental model to assess the consequences of gastric surgeries on gastric motility. We investigated the effects of proximal gastrectomy (PG) using a non-invasive technique (alternate current biosusceptometry [ACB]) on gastric contractility (GC), gastric emptying (GE), and orocecal transit (OCT) after the ingestion of liquids and solids in rats. Twenty-four male rats were subjected to gastric motility assessment before and after the PG procedure. The GE and OCT results are expressed as the mean time of gastric emptying (MGET) and cecum arrival (MCAT). The GC recordings are presented as the frequency and amplitude of contractions. Mean time of gastric emptying after solid meals were significantly different (p<0.001) between control and PG (113±5 to 99±6min). Mean time of cecum arrival ranged from 265±9 to 223±11min (p<0.001) and 164±9 to 136±17min (p<0.050) for solid and liquid meals, respectively. The assessment of GC showed that surgery decreased the phasic frequency (4.4±0.4 to 3.0±1.1cpm, p<0.050) and increased the amplitude of contractions (3.6±2.7 to 7.2±3.0V/s, p<0.050). No significant difference was found in tonic frequency. The ACB system was able to assess GE, OCT, and GC in gastrectomized rats. Overall, PG accelerated GE and gastrointestinal transit, likely due to the increase in both intragastric pressure and amplitude contraction. Our data presented an efficient model to investigate functional consequences from gastric surgeries that will allow further studies involving different procedures.

Surgical models of Roux-en-Y gastric bypass surgery and sleeve gastrectomy in rats and mice.

Bariatric surgery is the only definitive solution currently available for the present obesity pandemic. These operations typically involve reconfiguration of gastrointestinal tract anatomy and impose profound metabolic and physiological benefits, such as substantially reducing body weight and ameliorating type II diabetes. Therefore, animal models of these surgeries offer unique and exciting opportunities to delineate the underlying mechanisms that contribute to the resolution of obesity and diabetes. Here we describe a standardized procedure for mouse and rat models of Roux-en-Y gastric bypass (80-90 min operative time) and sleeve gastrectomy (30-45 min operative time), which, to a high degree, resembles operations in humans. We also provide detailed protocols for both pre- and postoperative techniques that ensure a high success rate in the operations. These protocols provide the opportunity to mechanistically investigate the systemic effects of the surgical interventions, such as regulation of body weight, glucose homeostasis and gut microbiome.

Fructooligosaccharide Consumption Improves the Decreased Cortical Bone Following Gastrectomy in Rats

Fructooligosaccharide Consumption Improves the Decreased Cortical Bone Following Gastrectomy in Rats

Gastroduodenal feeding after gastric bypass: a response to the comment by Jorgensen et al.

we appreciate the constructive comments by Jorgensen et al. in their Letter to the Editor ([8][1]) regarding our recent paper comparing post-Roux-en-Y gastric bypass (RYGB) metabolic responses to a mixed meal delivered to the jejunum (orally) or the gastroduodenum via a gastrostomy tube ([6][2]).

Sleeve Gastrectomy in Rats Improves Postprandial Lipid Clearance by Reducing Intestinal Triglyceride Secretion

Postprandial hyperlipidemia is a risk factor for atherosclerotic heart disease and is associated with the consumption of high-fat diets and obesity. Bariatric surgeries result in superior and more durable weight loss than dieting. These surgeries are also associated with multiple metabolic improvements, including reduced plasma lipid levels. We investigated whether the beneficial effects of vertical sleeve gastrectomy (VSG) on plasma lipid levels are weight independent. VSG was performed on Long-Evans rats with diet-induced obesity. Controls were sham-operated animals who were either pair-fed or ad libitum-fed. We measured fasting and postprandial levels of plasma lipid. To determine hepatic and intestinal triglyceride secretion, we injected the lipase inhibitor poloxamer 407 alone or before oral lipid gavage. (13)C-Triolein was used to estimate postprandial uptake of lipid in the intestine. Rats that received VSG and high-fat diets had markedly lower fasting levels of plasma triglyceride, cholesterol, and phospholipid than obese and lean (pair-fed) controls that were fed high-fat diets. Rats that received VSG had a marked, weight-independent reduction in secretion of intestinal triglycerides. VSG did not alter total intestinal triglyceride levels or size of the cholesterol storage pool nor did it affect the expression of genes in the intestine that control triglyceride metabolism and synthesis. VSG did not affect fasting secretion of triglyceride, liver weight, hepatic lipid storage, or transcription of genes that regulate hepatic lipid processing. VSG reduced postprandial levels of plasma lipid, independently of body weight. This resulted from reduced intestinal secretion of triglycerides following ingestion of a lipid meal and indicates that VSG has important effects on metabolism.