| 【Objective】We design the experiment to study the hypoglycemic action of duodenal-jejunal bypass,new biliopancreatic bypass,duodenal-jejunal exclusion in type 2 diabetic rat model,and lipids malabsorption caused by all 3 kinds of sugeries and different length of alimentary limb,biliopancreatic limb and common limb,and to explore the possible mechanism of bariatric surgery.【Methods】1、68 male 5-week-old SPF SD rats,high fat and high sugar diet for 8 weeks, intraperitoneal injection of low-dose(40mg/Kg) streptozotocin to establish type 2 diabetic rat model, random blood glucose screening≥16.7mmol/L as type 2 diabetes model; the 37 type 2 diabetic rats were randomly divided into 4 groups underwent duodenal-jejunal bypass(DJB group 9),new biliopancreatic bypass(NBPD group 10), duodenal-jejunal exclusion(DJE group 10), sham operation group(S group 8).2、Food intake,fasting body weight,random blood glucose(PG), fasting plasma glucose(FPG) and 2h-postprandial glucose(2h- PG) were tested in 1 week before surgery and 1,2,4,6,8 weeks after surgery.3、Oral glucose tolerance test(OGTT) was tested 1 week before surgery and 4 and 8 weeks after surgery.4、Stool triglyceride levels and triglyceride fecal excretion rate were tested 2 week before surgery and 3 and 6 weeks after surgery.5、Urinary D- xylose excretion rate were tested 2 week before surgery and 4,6,8 weeks after surgery.【Results】1、1 week before surgery, fasting weight was not significantly different in all groups. 2 weeks after surgery,fasting body weight of DJB group and NBPD group weresignificantly lower than sham group.1 week,4 weeks,6 weeks,and 8 weeks after surgery,fasting weight were not significantly different in all groups.2、Food intake was not significantly different in all groups before and after surgery.3、Preoperative and postoperative each week,fasting blood glucose in all groups were not significantly different.1 week before surgery,2-hour postprandial blood glucose was not significantly different in all groups.1 week after surgry,2-hour postprandial blood glucose of DJB,NBPD group were significantly less than DJE group and sham group,and DJB group was significantly less than NBPD group. 2 weeks,4 weeks and 6 weeks after surgery, 2-hour postprandial blood glucose of DJB group and NBPD group were significantly less than DJE group and sham group.8 weeks after surgery, 2-hour postprandial blood glucose of DJB groupwere significantly less than NBPD group, DJE group and sham group.4、1 week before surgery, blood glucose of each group at each time point in glucose tolerance test were not significantly different. Postoperative 4 weeks, 120 min blood glucose of DJB group, NBPD group and DJE group were significantly lower than sham group. DJB group, NBPD group, DJE group blood glucose peak close to 60 minutes, blood glucose peak of sham group close to 120 minutes.8 weeks after surgery,blood glucose of each group at each time point in glucose tolerance test were not significantly different. Preoperative and postoperative 4 weeks, 8 weeks, no significant difference between the area under the curve of glucose tolerance among the groups.5、2 weeks before surgery, fecal triglyceride level and triglyceride fecal excretion rate of each group were not significantly different.3 weeks and 6 weeks after surgery, fecal triglyceride level and triglyceride fecal excretion rate of DJB group and NBPD group were significantly higher than DJE group and sham group,and DJB group was significantly higher than NBPD group.Fecal triglyceride level and triglyceride fecal excretion rate of 6 weeks after surgery were significantly less than 3 weeks after surgery.6、Urinary D- xylose excretion rate in 2 weeks before surgery and 4 weeks after surgery were not significantly different.6 weeks after surgery,urinary D- xylose excretion rate of DJB group, NBPD group and DJE group weresignificantly lower than sham group.8 weeks after surgery, urinary D- xylose excretion rate of DJB group and DJE group were significantly lower than NBPD group and sham group.【Conclusion】1、DJB impacts on lipid digestion and absorption distinctly,and improves blood glucose more than other groups. NBPD impacts on lipid digestion and absorption,and followed by hypoglycemic effect too.But not so effective as DJB. DJE does not affect the digestion and absorption of lipids,or improve blood glucose.2、Shortening the 20 cm common limbof type 2 diabetic rat does not affect the digestion and absorption of lipids, it will not cause obvious hypoglycemic effect.3、Simply extend the alimentary limb can affect food digestion and absorption of lipids and play a hypoglycemic effect, but it will becompensated easily.4 、 Thecombined action of biliopancreatic limb and alimentary limb cause significant lipids malabsorption,and stable hypoglycemic effect.5、Duodenum and upper jejunum exclusion can reduce intestinal compensatory, which may help maintain hypoglycemic effect afterbariatric surgery. |
