Effects Of Preoperative Ketogenic Diet On Early Inflammation,Glucose And Lipid Metabolism After Sleeve Gastrectomy In Mice

Objective:In this study,mice were fed with ketogenic diet for 28 days before operation.After the operation,the sleeve gastrectomy model was established.The levels of inflammatory factors in plasma and glucose and lipid metabolism in liver tissue of mice were observed 24 hours after operation,and the effects of preoperative ketogenic diet on early inflammation and glucose and lipid metabolism after sleeve gastrectomy in obese mice were preliminarily explored.In order to provide a clinically practical plan and a strong evidence basis for the preoperative dietary care of patients with sleeve gastrectomy and provide new ideas for the exploration of preoperative dietary care for surgical patients.Method:C57 mice were randomly divided into ketogenic diet blank group(KD blank group),ketogenic diet sham operation group(KD sham operation group),ketogenic diet operation group(KD operation group),control diet blank group(CD blank group),control diet sham operation group(CD sham operation group)and control diet operation group(CD operation group),each group n=8.The three groups of ketogenic diet and the three groups of control diet were treated with isocaloric ketogenic diet and standard diet for 28 days.After dietary intervention,sleeve gastrectomy was performed in KD operation group and CD operation group,and sham operation was performed in KD sham operation group and CD sham operation group.The body weight and blood glucose of mice were measured every week,immediately before operation and 24 hours after operation;Blood ketones were measured after dietary intervention,immediately before operation and 24 hours after operation.At 24h postoperatively,the plasma concentrations of IL-1β,IL-6 and TNF-α in mice were determined by ELISA,and the expression of NF-κB,SCD-1,FASN,PEPCK and PCK-1 in mouse liver tissues was detected by RT-qPCR.The levels of CD3+,CD4+and CD8+ in peripheral blood T lymphocytes and body fluids of mice were observed by flow cytometry.The distribution of glycogen in mouse liver was observed by PAS staining.Results:(1)After 21 days of dietary intervention,the weight of the mice in each group that ate the ketogenic diet was significantly lower than that of the mice in the control diet(P<0.05),and there was no significant difference between the weight of the mice in the preoperative and postoperative 1st innate ketone diet surgery group and the control diet surgery group(P>0.05).(2)There was no difference in preoperative and postoperative blood glucose between the mice in each group(P>0.05).(3)After 28 days of dietary intervention,the blood ketone levels of the mice in each group fed on the ketogenic diet were higher than those in each group of mice that ate the control diet(P<0.05);the blood ketone levels of the mice in each group on the ketogenic diet before surgery were closer to the blood ketone levels in each group of mice on the control diet(P>0.05);on the first day after the operation,the blood ketone levels of the mice in each group of the ketogenic diet were higher than those in each group of mice in the control diet group(P<0.05).(4)At the 24-hour after operation,the expression levels of plasma inflammatory cytokines IL-1β and IL-6 in the ketogenic diet surgery group decreased compared with the mice in the control diet surgery group(P<0.05);the NF-κB level of liver was reduced in the ketogenic diet surgery group(P<0.05).(5)At the 24-hour after operation,the counts of peripheral blood lymphocytes CD3+、CD4+、CD8+in the control diet surgery group were lower than those in the control diet blank group(P<0.05),and the counts of peripheral blood lymphocytes CD3+、CD4+、CD8+in the ketogenic diet surgery group were lower than those in the ketogenic diet blank group(P<0.05).Postoperative peripheral blood lymphocytes CD3+、CD4+、CD8+in the ketogenic diet surgery group were closer to the mice in the control diet surgery group(P>0.05)(6)At the 24-hour after operation,the expression levels of SCD-1,FASN,PEPCK and PFK-1 in the liver of the ketogenic diet blank group were lower than those of the control diet blank group(P<0.05);The expression levels of SCD-1,FASN,PEPCK and PFK-1 in the ketogenic diet sham operation group were lower than those in the control diet sham operation group(P<0.05);The expression levels of SCD-1,FASN,PEPCK and PFK-1 in the ketogenic diet group were lower than those in the ketogenic diet group(P<0.05).Conclusion:In this study,the ketogenic diet was used to intervene the diet of mice before sleeve gastrectomy for 28 days.It was found that the ketogenic diet also had a certain regulatory effect on the weight of normal mice.At the 24-hour after operation,the expression levels of inflammatory cytokines IL-1β,IL-6,TNF-α and liver NF-κB were detected,and it was found that preoperative ketogenic diet inhibited the expression of inflammation after sleeve gastrectomy in mice..Through the detection of SCD-1,FASN,PEPCK,PFK-1 gene expression levels in mouse livers,it was found that the preoperative ketogenic diet could inhibit the synthesis of fatty acids and gluconeogenesis after sleeve gastrectomy in mice,which was caused by the unique metabolic state of the ketogenic diet.These data suggest that preoperative ketogenic diet can enable mice to show a unique metabolic state and reduce early postoperative inflammation.