Residual Gastric Dilatation Interferes with Metabolic Improvements Following Sleeve Gastrectomy by Upregulating the Expression of Sodium-Glucose Cotransporter-1
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Sleeve gastrectomy (SG) is widely used in treating obesity because of significant weight loss and anti-diabetic effects, but there are still cases of long-term weight loss failure. Our aim was to explore the weight loss mechanism following SG in mice to learn how initial improvements in glucose metabolism are reversed in the long term.
C57/BL6 mice were divided into two groups, one undergoing SG and the other sham surgery. Body weight, gastric volume, blood glucose level, and the expression of sodium-glucose cotransporter 1 (SGLT1) were assessed at 2 weeks, 1 month, and 2 months after surgery.
The SG mice had reduced food intake and lost weight during the 30 days after surgery. However, food intake and weight recovered gradually and even surpassed the sham group after 30 days. SGLT1 expression decreased within 1 month after SG and then increased at 2 months. Although initial SGLT1 expression levels in the stomach were much lower than at intestinal sites, levels increased following surgery and then decreased. The gastric volume decreased after SG, but was significantly increased at 2 months, exceeding the gastric volume in the sham mice.
The metabolic benefits of SG are achieved through reduced gastrointestinal glucose absorption as evidenced by decreased expression of SGLT1 without bypassing the proximal intestine as in other forms of bariatric surgery. In addition, SGLT1 expression in the stomach may play a greater role in post-surgical metabolic effects, but further studies are needed.
KeywordsSleeve gastrectomy Obesity Weight loss Type 2 diabetes SGLT1 Glucose absorption Residual gastric volume
We would like to acknowledge the assistance of John T. Cathey in language.
This research was supported by National Natural Science Foundation of China (81500396), Foundation of Sichuan Educational Committee (18CZ0023), Foundation of Sichuan Health Committee (18PJ496), Nanchong Government and North Sichuan Medical College Cooperation Project(18SXHZ0307), and Foundation of North Sichuan Medical College (CBY15-QD001).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All applicable institutional and/or national guidelines for the care and use of animals were followed.
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