The Therapeutic Effects Of Different Gastric Palication Surgeries For Type2Diabetes In Goto-Kakizaki Rats

Part Ⅰ:The establishment of different gastric plication surgeries GK rat modelsObjective:To establish stable GK Rats models which respectively underwent the operation of Nissen fundoplication, greater curvature placation(GCP), Nissen fundoplication plus GCP and sleeve gastrectomy(SG).Methods:There were2520-weekold GK Rats involved in this study. The rats were put into5groups randomly, undergoing different surgical procedures such as non-operation, the Nissen fundoplication, GCP, Nissen fundoplication plus GCP, and SG. The body weight and change of the fat content were under monitoring before and after the operation in an8-week duration. Meanwhile surgical mortality rate and morbidity situation of our experiment were also evaluated in our study.Results:The post-operative body weight, the inguinal and peri-renal fat mass of the operative GK rats were significantly decreased compared to the non-operation group.(P<0.05) The body weight of GK rats underwent different surgical procedures various from each other. The Nissen Fundoplication Group weighed443.2±17.6g on average and the GCP group was445.8±4.3g8weeks after operation, showing no statistical significance between those two operations. The Nissen Fundoplication plus GCP Group weighed averagely486.2±7.6g and were significantly heavier than the GCP group, which was on average401.4±11.3g8weeks after operation, showing no statistical significance between those two operations.(P<0.05) Surgical mortality rate and morbidity situation of this model were relatively low, and the achievement ratio of this model was up to90%. Conclusion:We succeeded establishing the model of different gastric plication surgeries on GK Rats, which would provide stable environment for the further investigation of surgical mechanism. Part Ⅱ:The Effects of Different Gastric Plication Surgeries as a Treatment for Type-2Diabetes in GK RatsObjective:To study the therapeutic effects of the Nissen fundoplication group, the GCP group and the Nissen fundoplication plus GCP group of the modeled GK rats, and to further compare them with the SG group, in order to make the assessment of curative effect.Methods:The rats were put into5groups randomly, undergoing different surgical procedures such as non-operation, the Nissen fundoplication, GCP, Nissen fundoplication plus GCP, and SG. The body weight and change of the fat content were under monitoring before and after the operation in an8-week duration. The Blood Glucose(BG) level and the plasma insulin(PI) level of all rats were tested separately at the time points of2,4,6,8weeks post-operatively. OGTT were proceeded4weeks after the surgery. And hyperglycemic clamps was applied to evaluate the function of islet β cell8weeks after operation.Results:The post-operative body weight of the GK rats underwent operation were significantly lighter than the non-operation group.(P<0.05) Before the surgeries, there were no significant difference on the BG level between all5GK rat groups, which is11mmol/L averagely (P>0.05). However,8weeks after the surgery, the BG level were on average11.4±0.6mmol/L in non-operation group,9.3±0.8mmol/L in Nissen Group,7.7±0.4mmol/L in GCP group,6.2±0.5mmol/L in Nissen plus GCP group and5.5±0.5mmol/L in SG group, and they are significantly different from each other.(P<0.05) While in the hyperglycemic clamps test(HCT), those rats in the operation groups were both sharper to insulin and excreting much more hormone.8weeks after surgery, the glucose infusion rate(GIR) were on average6.5±0.7in non-operation group,9.4±0.6in Nissen Group,13.4±1.1in GCP group,13.4±0.7in Nissen plus GCP group and17.5±1.9in SG group on condition that the hyperinsulinemic-euglycemic clamp is stable. Though there seems no statistical variation between the GCP and Nissen plus GCP group (P=0.97), the rest showed statisitical significance with each other group.(P<0.05) The AUC of their insulin level were1282.4±114.2mU·min/L in non-operation group,2018.1±111.9mU·min/L in Nissen group,4168.4±132.2mU·min/L in GCP group,4415.0±153.4mU·min/L in Nissen plus GCP group and5328.5±316.8mU·min/L in SG group, and reported significant when comparing each two groups of them.(P<0.05)Conclusion:Comparing with the non-operation group, all GK rats from operation groups showed progress in recovery of diabetes Mellitus, of which the fasting BG and glucose tolerance improved apparently, and the insulin sensitivity and glucose-dependent insulin excretion increased. The therapeutic effect of SG on diabetic rats were remarkable, while the GCP or Nissen plus GCP surgery also recieved fair results. Among all Nissen group were the least effective operative method in this model.