The Impact Of Duodenal-jejunal Bypass On Blood Glucose And Serum Lipid In T2DM Model Rats

?Objective?We performed duodenal-jejunal bypass surgery(DJB),new billio-pancreatic diversion surgery(NBPD) and duodenal-jejunal exclusion surgery(DJE) respectively on T2 DM model rats, then observed the impact of duodenal-jejunal bypass on blood glucose and serum lipid in T2 DM model rats, to explore the mechanism of surgical treatment of diabetes.?Methods?1. T2 DM model rats were induced by high fat diet and STZ on SD rats.2. T2 DM model rats were randomly assigned to four groups, as follows,DJB group=9,NBPD group=10,DJE group =10,Sham group=8.3. Body weight,food intake,fasting plasma glucose(FPG), 2-hour postprandial blood glucose(2h-PG) were measured respectively on 1week preoperatively and weeks1,2,4,6,8,after sugery?4. OGTT tests were performed on 1week preoperatively and weeks 4 after sugery?5. Fasting and 2-hour postprandial plasma free fatty acids(FFAs), triglycerides(TG)cholesterol(CH), bile acids(BAs) levels were detected on 1week preoperatively and weeks 4 after sugery?6. Fasting and 2-hour postprandial plasma insulin(INS) and glucagon-like peptide-1(GLP-1) levels were detected on 1week preoperatively and weeks 5 after sugery??Results?1.Body weight of rats was on the rise postoperatively. The body weight of group DJB,NBPD was lower than group Sham at weeks 2 after sugery(P<0.05), in other monitoring point there was no significant difference between four groups(P>0.05).The food intake was fluctuant postoperative, but there was no significant difference between four groups on the monitoring point.2. There was no significant difference in FPG between four groups postoperatively. The The level of 2h-PG in groups DJB,NBPD and DJE was lower than their preoperative levels from week 1 after sugery(P<0.05),the groups of DJB,NBPD showed lower values than Sham group on each monitoring point postoperatively(P<0.05), but NBPD turn to be no significant difference with Sham group at weeks 8 after sugery(P>0.05). At weeks 4 after surgery, there was significant difference in AUC OGTT between groups of DJB,NBPD and Sham(P<0.05),the values of DJB and NBPD were lower.3. Regardless of fasting or 2-hour postprandial levels,there is no significant difference between four groups in GLP-1 and INS(P>0.05).4. At weeks 4 after sugery, regardless of fasting or 2h postprandial FFAs, TG, CH, there were significant differences between DJB group and Sham group(P<0.05),DJB group was always lower. NBPD group exhibited lower values than Sham group on fasting and 2h postprandial TG(P <0.05). Only fasting TG,DJE group was lower than Sham group(P <0.05).5. At weeks 4 after sugery,group DJB,NBPD showed significant higher vlaues of fasting serum BAs than Sham group(P <0.05).?Conclusion?1.DJB,NBPD and DJE group did n't improved FPG obviously. DJB was better than DJE on improving 2h-PG and glucose tolerance. DJE group did n't improve glucose homeostasis obviously.2. DJB can improve the overall levels of serum lipid, NBPD can improve fasting and 2h postprandial TG, DJE only improved fasting TG level.3.DJB, NBPD can increase the fasting serum BAs concentration,and it may contribute to the improvement of blood glulcose and serum lipid.4.The influence of DJB, NBPD and DJB on plasma GLP-1 level is not obvious, GLP-1 may not be the main reason for diabetes remission.