Effects Of Duodenal-jejunal Bypass And New Billiopancreatic Diversion Surgery On Glucose And Intestinal Hormonal In Type2Diabetes Rats

【Objective】The aim of this study was to investigate the effect of duodenal-jejunal bypass(DJB) and new biliopancreatic diversion surgery（NBPD）on glucose. To observe theeffect on glucose, intestinal hormones and insulin with three major nutrients; and therelationship between glucose and intestinal hormones in type2diabetes mellitus(T2DM) rats, which explored the possible mechanisms of DJB treatment of T2DM.【Methods】1、Sixty5-week-old male Sprague-Dawley (SD) rats. A T2DM rat model wasdeveloped by a high-fat diet and low dose of streptozotocin. Thirty-three diabetic ratswere randomly assigned to the DJB group (n=12), NBPD group (n=11), and shamgroup (n=10).2、Each group of T2DM rats, Body weight and fasting plasma glucose (FPG)was detected1week before surgery and1,2,4,6,8,10weeks after surgery in the fastingstate, and2-hour Postprandial Glucose(2h-PG) was measured2-hours after themixed-meal3、After surgery After18-20days,24-26days27-29days30-32days wereused peanut oil, starch, Ansul and egg white was administered by oral gavage at adose of8kcal/Kg body wt. Glucose level from tail vein blood samples were measuredat60,120, and180min after meal administration. At0,30min, plasma samples werecollected and stored at-80°C until GIP, GLP-1and INS assays, calculate the areaunder the glucose curve, and plasma GIP, GLP-1and INS level were detected byELISA.【Results】1、 No significant difference in fasting body weights between groups before surgery. After surgery, each group of fasting body weight gradually increased1and2weeks after surgery, DJB group and NBPD group was significantly lower than shamgroup. From4weeks to10weeks after surgery, compared with sham group, fastingbody weight in DJB group and NBPD group have no significant difference. From6weeks to10weeks after surgery, DJB group was significantly higher than NBPDgroup.2、Before and after surgery, each group of fasting blood glucose level showedno significant difference in the same week. From1weeks to10weeks after surgery,2hours postprandial glucose (2h-PG) in DJB group and NBPD group was significantlylower than sham group. From6weeks to10weeks after surgery,2h-PG in DJB grouplower than NBPD group, but there have no significant difference between DJB groupand NBPD group.3、 After starch gavage, blood glucose and glucose under the curve was thesmallest in DJB group, then NBPD group, and the biggest in sham group, and havesignificant difference was found between DJB group and sham group. Before gavage,each group of fasting plasma Gastric Inhibitory Polypeptide（GIP）, Glucagon LikePeptide-1（GLP-1） and Insulin（INS）level has no significant difference.30min afterstarch gavage, DJB and NBPD group plasma GIP level were significantly higher thanthe sham group. DJB group plasma GLP-1level was significantly higher than shamand NBPD group. Plasma INS level was increased in DJB group, but there has nosignificant differences among the three groups.4、After peanut oil gavage, blood glucose and glucose under the curve have nosignificant difference between groups. Before gavage, each group of fasting plasmaGIP, GLP-1and INS level has no significant difference.30min after peanut oil gavage,plasma GIP level was increased in sham group, DJB group and NBPD group was not,while there have no significant difference between groups; DJB group and NBPDgroup plasma GLP-1level was significantly higher than sham group; plasma INSlevel has no significant difference between groups.5、After egg white gavage, blood glucose and glucose under the curve have nosignificant difference between groups. Before gavage, each group of fasting plasma GIP, GLP-1and INS level has no significant difference.30min after peanut oil gavage,plasma GIP level was increased in sham group, DJB group and NBPD group was not,DJB group and NBPD group plasma GIP level was significantly higher than shamgroup; DJB group and NBPD group plasma GLP-1level was significantly higher thansham group; plasma INS level has no significant difference between groups.6、 After Ansul gavage, blood glucose and glucose under the curve was thesmallest in DJB group, then NBPD group, and the biggest in sham group, and havesignificant difference was found between DJB group and sham group. Before gavage,each group of fasting plasma GIP, GLP-1and INS level has no significant difference.30min after Ansul gavage, DJB group plasma GIP level were significantly lower thanNBPD group and sham group. DJB group plasma GLP-1and INS level weresignificantly higher than NBPD group and sham group.【Conclusion】1、 Duodenal-jejunal bypass surgery (DJB) can significantly improvepostprandial glucose in T2DM rats, and the mechanisms maybe associated withintestinal exclusion and biliopancreatic diversion, which may increase plasma GLP-1level, and then leading to an increased insulin secretion.2、 New Biliopancreatic Diversion surgery can significantly improvepostprandial glucose in T2DM rats, the mechanisms maybe associated with onlybiliopancreatic diversion and without intestinal exclusion, which may affect a certainof the major food digestion and absorption and without significant increase plasmaGLP-1level.