Key result
High-fat diet reversed the improvement in glucose homeostasis after sleeve gastrectomy and duodenal-jejunal bypass in rats, correlating with re-impaired insulin sensitivity rather than beta-cell function.
In a diabetic rat model, diabetes recurrence after metabolic surgery induced by a high-fat diet correlates with re-impaired insulin sensitivity rather than beta-cell dysfunction.
May implicate re-impaired insulin sensitivity in rat-model recurrence; leaves open translation to human SG/DJB outcomes.
AIM: To investigate factors causing diabetes recurrence after sleeve gastrectomy (SG) and duodenal-jejunal bypass (DJB). METHODS: SG and DJB were performed on rats with diabetes induced by high-fat diet (HFD) and streptozotocin (STZ). HFD was used to induce diabetes recurrence at 4 wk postoperatively. Body weight, oral glucose tolerance test, homeostatic model assessment of insulin resistance (HOMA-IR), insulin signaling [IR, insulin receptor substrate (IRS)1, IRS2, phosphatidylinositol 3-kinase and AKT in liver and skeletal muscle], oral glucose stimulated insulin secretion, beta-cell morphology (mass, apoptosis and insulin secretion), glucagon-like peptide (GLP)-1, PYY and ghrelin were compared among SG rats with common low-fat diet (SG-LFD), SG with HFD (SG-HFD), DJB rats with LFD (DJB-LFD), DJB with HFD (DJB-HFD) and sham-operation with LFD (Sham) at targeted postoperative times. RESULTS: SG and DJB resulted in significant improvement in glucose tolerance, lower HOMA-IR, up-regulated hepatic and muscular insulin signaling, higher levels of oral glucose-stimulated insulin secretion, bigger beta-cell mass, higher immunofluorescence intensity of insulin, fewer transferase-mediated dUTP-biotin 3' nick end-labeling (TUNEL)-positive beta cells and higher postprandial GLP-1 and PYY levels than in the Sham group. The improvement in glucose tolerance was reversed at 12 wk postoperatively. Compared with the SG-LFD and DJB-LFD groups, the SG-HFD and DJB-HFD groups showed higher HOMA-IR, down-regulated hepatic and muscular insulin signaling, and more TUNEL-positive beta cells. No significant difference was detected between HFD and LFD groups for body weight, glucose-stimulated insulin secretion, beta-cell mass, immunofluorescence intensity of insulin, and postprandial GLP-1 and PYY levels. Fasting serum ghrelin decreased in SG groups, and there was no difference between HFD-SG and LFD-SG groups. CONCLUSION: HFD reverses the improvement in glucose homeostasis after SG and DJB. Diabetes recurrence may correlate with re-impaired insulin sensitivity, but not with alterations of beta-cell function and body weight.
No takes yet. Share an insight, caveat, or question.
Liu et al. (2017) studied Diabetes. High-fat diet post-surgery vs. Low-fat diet and sham operation was evaluated on Glucose tolerance, HOMA-IR, insulin signaling, and beta-cell morphology. High-fat diet reversed the improvement in glucose homeostasis after sleeve gastrectomy and duodenal-jejunal bypass in rats, correlating with re-impaired insulin sensitivity rather than beta-cell function.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: