| Objective:Bariatric surgery has been used in the treatment of obesity since 1950s.It can bring significant weight loss and long-term remission of serious obesity related complications,including hypertension.The mechanism of hypertension remission after bariatric surgery has been a research hotspots.This study aims to analyze the association between hypertension remission,urinary sodium excretion and renal sodium hydrogen exchanger 3(NHE3)after bariatric surgery in spontaneously hypertensive rats.we also analyzed the correlation between urinary sodium excretion with serum gastrin,ghrelin,insulin and GLP-1,to explored the mechanism of bariatric surgery on sodium excretion and hypertension remission.Methods:Spontaneously hypertensive rats(SHR)(n=24)were randomly divided into three groups:Roux-en-Y reconstruction with total gastrectomy group(RYTG group,n=8),duodenal jejunal bypass group(DJB group,n=8)and sham operation group(sham group,n=8).The tail artery blood pressure,body weight,24-hour urinary sodium excretion,serum gastrin,ghrelin,insulin,glucagon like peptide-1 were detected at baseline and 1-8 weeks after operation in spontaneously hypertensive rats.The expression of sodium hydrogen exchanger 3 in renal proximal tubules was detected by Western blot and immunohistochemistry at 8 weeks after operation.Results:1)There was no significant difference in blood pressure among the three groups(P>0.05);At the second week after operation,the blood pressure of RYTG group continued to decrease significantly,while that of DJB group only decreased slightly(RYTG group 167.7±4.9mmHg vs DJB group 170.1±6.3mmHg vs SHAM group 181.6±4.4mmHg,P<0.05);4 weeks after operation,the blood pressure of each group tended to be stable,RYTG group was significantly lower than DJB group and sham group,the difference was statistically significant(RYTG group 166.2±6.2mmHg vs DJB group 179.4±4.1mmHg vs SHAM group 185.6±5.0mmHg,P<0.05);At the 8th week after operation,the blood pressure of each group was basically the same as that at the 4th week after operation.2)There was no significant difference in body weight between groups before and 1 week after operation(P>0.05);At the second week after operation,compared with DJB group and sham group,the body weight of RYTG group decreased slightly,but the difference was not statistically significant(P>0.05).4 weeks after operation,RYTG group began to show significant weight loss(RYTG group 255.7±7.9g vs DJB group 273.9±7.2g vs SHAM group 282.9±8.7g,P<0.05)。At the 8th week after operation,the body weight of RYTG group was basically the same as that at the 4th week after operation,while the body weight of DJB group and sham group increased significantly(RYTG group 253.3±8.5g vs DJB group 284.9±6.7g vs SHAM group 302.8±5.8g,P<0.05).3)In the first week after operation,the urinary sodium excretion of RYTG group and DJB group was slightly lower than that of sham group;At the second week after operation,the urinary sodium excretion of RYTG group increased significantly compared with sham group(RYTG group 1.77±0.18mmol/24h vs DJB group 1.64±0.09mmol/24h vs SHAM group 1.59±0.12 mmol/24h,P<0.05);At the 4th week after operation,the urine sodium of RYTG group and DJB Group continued to increase(RYTG group 1.8810.12 mmol/24h vs DJB group 1.74±0.13mmol/24h vs SHAM group 1.58±0.13 mmol/24h P<0.05);At the 8th week after operation,the urinary sodium excretion in RYTG group and DJB group was significantly lower than that at the 4th week after operation,and that in sham group was basically the same as that at the 4th week after operation.4)At the first week after operation,there was no significant change in serum glucagon like peptide-1 in RYTG group,but the serum concentrations of insulin,gastrin and ghrelin decreased significantly;At the fourth week after operation,serum glucagon like peptide-1 in RYTG group and DJB group increased significantly(RYTG group 20.38±3.04pmol/L vs DJB group 16.03±2.45pmol/L,P<0.05),but there were no significant changes in serum gastrin,ghrelin and insulin levels compared with the first week after operation;At the 8th week after operation,the serum glucagon like peptide1 in RYTG group and DJB group decreased slightly;At the 8th week after operation,the levels of gastrin,ghrelin and insulin remained stable;5)At the 8th week after operation,the expression of sodium hydrogen exchanger 3 in kidney of rytg group and DJB group was higher than that of sham group.Conclusion:1)Bariatric surgery can significantly reduce blood pressure in spontaneously hypertensive rats,especially after total gastrectomy;2)Hypertension remission may be related to the increase of urinary sodium excretion in spontaneously hypertensive rats;3)The increased expression of sodium hydrogen exchanger 3 in the kidney may be regulated by negative feedback and participate in the maintenance of sodium homeostasis after bariatric surgery;4)The increase of urinary sodium excretion after bariatric surgery may be related to serum glucagon like peptide-1. |
PDF Full Text Request