Effects Of Vitamin D Control Treatment On Metabolism And Chronic Inflammation In Obese Mice After Bariatric Surgery

Part one Effects of vitamin D control treatment on metabolism and chronic inflammation in obese mice after bariatric surgeryObjectiveThe relationship between vitamin D levels,obesity and inflammatory state is not well understood so far.The purpose of this study was to establish an obesity mouse model induced by vitamin D deficiency(VDD)diet,and then to investigate the effect of vitamin D on metabolism and inflammation status in mice with sleeve gastectomy.MethodA total of thirty-six 4-week-old male C57BL/6J mice were fed standard diet with and without vitamin D and high-fat diet for 14 weeks to establish a model of vitamin D deficiency and obesity.Four groups were divided:control group(Ctrl,N=6),vitamin D deficiency group(VDD,n=6),high-fat diet group(HFD,n=12),and high-fat diet+vitamin D deficiency group(HFD+VDD,n=12).Compared with control group mice,diet-induced obesity(DIO)mice(including HFD mice and HFD+VDD mice)had significantly increased body weight,plasma VD3 concentration of HFD+VDD mice was significantly lower than that of HFD mice,and blood glucose level of DIO mice also significantly increased,confirming successful modeling of obese mice.HFD mice and HFD+VDD mice were randomly divided into two weight-matching groups for VSG or Sham surgery.The mice were given the same diet for another 12 weeks after surgery,and then killed.All the mice recorded their weight and food intake on a weekly basis.At 14 weeks,blood was taken from the eyes of mice and plasma vitamin D concentrations were measured.On the day before the death,blood was collected from the tail vein of mice,blood glucose and insulin concentrations were measured,and OGTT test was performed simultaneously.After the mice were killed,blood was collected and blood concentrations of vitamin D,triglycerides,alanine aminotransferase,alanine aminotransferase and plasma secretion of inflammatory factors LPS,IL-1 and IL-10 were measured.Visceral fat was weighed and sliced for HE staining.ResultsCompared with sham group mice,HFD group and HFD+VDD group hadsimilar weight loss in the first 6 weeks after VSG.Compared with sham group mice,the food intake of mice after VSG was reduced,and the food intake of all mice after 7 weeks was basically similar.Both HFD-VSG and HFD+VDD-VSG mice lost weight after VSG.Compared with the corresponding sham group mice,the visceral fat weight of mice after VSG was significantly reduced(P<0.01),while the visceral fat weight of HFD-VSG mice was further reduced than that of HFD+VDD-VSG mice(P<0.05).Compared with sham group,VSG significantly improved adipocyte hypertrophy and steatosis in mice fed a high-fat diet(P<0.05),but this change was not significant in mice in the HFD+VDD group.Serum triglyceride,ALT and AST levels of mice after VSG were decreased,and ALT and AST levels of mice in THE HFD+VDD-VSG group were further reduced compared with those in the HFD+VDD-VSG group.Before VSG,there was no significant difference in fasting glucose level andglucose tolerance between HFD group and HFD+VDD group.After VSG operation,the fasting blood glucose and insulin levels of mice were significantly reduced,insulin resistance was significantly decreased,and glucose tolerance was improved,while the fasting blood glucose level of mice in the HFD-VSG group was significantly lower than that in the HFD+VDD-VSG group(P<0.05).The HFD-VSG group showed better reduced insulin resistance and improved glucose tolerance.After VSG,plasma LPS and IL-1 levels were significantly decreased,while IL-10 levels were increased.Compared with The HFD-VSG group,inflammatory factors in ileum of the HFD+VDD-VSG group were significantly changed.ConclusionVitamin D has a certain regulatory effect on the improvement of metabolic disorders after VSG,including maintaining weight loss,reducing insulin resistance,reducing intestinal inflammation,improving intestinal permeability,and improving intestinal flora disorders.These results suggest that maintaining the normal concentration of vitamin D in the blood circulation is of great clinical significance for the regulation of metabolic disorders after VSG.Part two The influence of different body mass index on the clinical effect of laparoscopic radical resection of rectal cancerObjectiveIn this study,a retrospective analysis of the clinical data of patients undergoing laparoscopic radical resection of rectal cancer was performed.The clinical effects of patients with different body mass index during the perioperative period,as well as the differences in related nutritional status and inflammatory indicators,were compared and analyzed to explore the influence of different body mass index on the clinical effects of patients undergoing laparoscopic radical resection of rectal cancer.MethodsFrom January 2014 to January 2019 in a university affiliated hospital patients,a total of 110 cases of laparoscopic assisted colorectal cancer radical,excluding the pathological results incomplete,low body mass index(BMI),and other parts of the merge operation,a history of malignancy or chemotherapy,patients with a history of most always have a stomach surgery,71 patients according to body mass index finally divided into overweight(BMI of 25 or higher)27 cases,normal weight group(BMI<25)of 44 cases,Serum albumin value,white blood cell,lymphocyte percentage,operation time,intraoperative blood loss,incidence of postoperative complications,lymph node acquisition,postoperative pathological results and other indexes were compared between the two groups before and after operation.ResultsAll patients successfully completed the operation,no transfer to open abdomen and intraoperative death cases.There were no significant differences between the two groups in age,sex,incidence of complications,tumor distance from the anal border,or history of abdominal surgery(P>0.05).The operative time was(247.84±62.96)min in the normal weight group and(261.29±52.48)min in the overweight group.The intraoperative blood loss was(87.27±96.84)ml in the normal weight group and(95.55±88.80)ml in the overweight group,and there was no significant difference between the two groups.Postoperative pathological results showed that there were no significant differences between the two groups in gross specimen type,negative rate of circumferentially cut edge,depth of tumor invasion of intestinal wall,average tumor diameter,average number of lymph nodes(including 253 groups of lymph nodes)and lymph node metastasis(P>0.05).There was no significant difference in serum CEA,CEA125,ca19-9 and AFP levels between the two groups(P>0.05).There was no significant difference in nutrition-related indicators(ALB,PA)and inflammation-related indicators(WBC,NEU%,NEU)between the two groups before surgery(P>0.05),while the hemoglobin of the normal weight group(127.90±13.35)g/L was significantly lower than that of the overweight group(135.74±16.99)g/L,with statistically significant difference(P<0.05).In addition,ALB,PA and HGB of the two groups were significantly decreased after surgery,while WBC,NEU%and NEU%were significantly increased.There was no significant difference in postoperative inflammatory stress related indicators(WBC,NEU%and NEU)between the two groups(P>0.05),while there was significant difference in ALB,PA and HGB between the normal weight group and the overweight weight group(P<0.05).Postoperative complications occurred in 17 cases(38.63%)in the normal weight group and 17 cases(62.96%,P<0.05)in the overweight group.ConclusionThis retrospective study has demonstrated that in patients with rectal cancer undergoing radical laparoscopic rectal cancer surgery with different body mass index,the incidence of postoperative complications in the overweight group was significantly increased compared with that in normal group,while the normal group had a higher risk of serum albumin reduction after surgery.Therefore,the perioperative management of patients undergoing laparoscopic rectal cancer surgery requires individualized consideration of the patient's condition,and the implementation of personalized surgery and nutrition program,so as to facilitate the accelerated recovery of patients with rectal cancer.