PMID- 31630290 OWN - NLM STAT- MEDLINE DCOM- 20210527 LR - 20230123 IS - 1432-2218 (Electronic) IS - 0930-2794 (Linking) VI - 34 IP - 10 DP - 2020 Oct TI - Distal gastric mucosa ablation induces significant weight loss and improved glycemic control in type 2 diabetes Sprague-Dawley rat model. PG - 4336-4346 LID - 10.1007/s00464-019-07200-3 [doi] AB - BACKGROUND: Excluding the foregut (distal stomach and duodenum) from food transit in RYGB normalizes glucose tolerance. Excluding/removing the duodenal mucosa partly improves glycemic control. So far, the effect of excluding/removing the gastric mucosa remains unknown. OBJECTIVE: To observe the effect of removing the distal gastric mucosa on glucose tolerance. METHOD: Thirty fatty Sprague-Dawley rats received low-dose streptozotocin (STZ) to induce type 2 diabetes (T2D), then randomly assigned to Roux-en-Y gastric bypass (RYGB, n = 8), distal gastric mucosa removal (DGMR, n = 8), duodenal-jejunal bypass (DJB, n = 8), and Sham (n = 6) groups. In the DGMR group, the distal third of the gastric mucosa was removed by thermal ablation using an electrocautery. Rats were followed for 8 weeks postoperatively. Preoperative oral glucose tolerance test (OGTT), insulin tolerance test (ITT), and mixed-meal tolerance test (MMTT) were repeated 3 and 6 weeks postoperatively. Changes in body weight, food intake, and fasting blood glucose were also recorded. RESULTS: Gastrin AUC decreased significantly (p < 0.05) in the DGMR group after surgery. A significantly increased GLP-1 AUC was found in the RYGB, DGMR, and DJB groups at week 3 and only the RYGB group at week 6 postoperatively. The improved glucose tolerance in the RYGB group was significantly greater than the improved glucose tolerance in the DGMR and DJB groups. The improved glucose tolerance 3 and 6 weeks after surgery in the DGMR group was significantly greater than the improved glucose tolerance in the DJB group. Body weight decreased significantly in the RYGB, DGMR, and DJB groups postoperatively. CONCLUSION: Removing the distal gastric mucosa induced significant weight loss and improved glycemic control in T2D SD rat model. Therefore, the gastric mucosa exclusion in RYGB may be key to the weight loss and diabetes remission, which perhaps warrants a new theory. FAU - Dolo, Ponnie Robertlee AU - Dolo PR AUID- ORCID: 0000-0002-6535-3574 AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. FAU - Huang, Ke AU - Huang K AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. FAU - Widjaja, Jason AU - Widjaja J AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. FAU - Li, Chao AU - Li C AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. FAU - Zhu, Xiaocheng AU - Zhu X AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. zhuxccf@163.com. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. zhuxccf@163.com. FAU - Yao, Libin AU - Yao L AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. FAU - Hong, Jian AU - Hong J AD - Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. AD - Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou, 221006, Jiangsu, People's Republic of China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20191019 PL - Germany TA - Surg Endosc JT - Surgical endoscopy JID - 8806653 RN - 0 (Bile Acids and Salts) RN - 0 (Blood Glucose) RN - 0 (Insulin) RN - 9007-41-4 (C-Reactive Protein) RN - 9011-97-6 (Cholecystokinin) SB - IM MH - Animals MH - Area Under Curve MH - Bile Acids and Salts/metabolism MH - Blood Glucose/metabolism MH - Body Weight MH - C-Reactive Protein/metabolism MH - Cholecystokinin/metabolism MH - Diabetes Mellitus, Experimental/blood/surgery MH - Diabetes Mellitus, Type 2/blood/*surgery MH - Fasting/blood MH - Feeding Behavior MH - Gastric Bypass MH - Gastric Mucosa/*surgery MH - Glucose Tolerance Test MH - *Glycemic Control MH - Insulin/blood MH - Male MH - Rats, Sprague-Dawley MH - *Weight Loss OTO - NOTNLM OT - Foregut OT - GLP-1 OT - Gastric bypass OT - Gastric mucosa OT - Gastrin OT - Type 2 diabetes EDAT- 2019/10/21 06:00 MHDA- 2021/05/28 06:00 CRDT- 2019/10/21 06:00 PHST- 2019/06/24 00:00 [received] PHST- 2019/10/09 00:00 [accepted] PHST- 2019/10/21 06:00 [pubmed] PHST- 2021/05/28 06:00 [medline] PHST- 2019/10/21 06:00 [entrez] AID - 10.1007/s00464-019-07200-3 [pii] AID - 10.1007/s00464-019-07200-3 [doi] PST - ppublish SO - Surg Endosc. 2020 Oct;34(10):4336-4346. doi: 10.1007/s00464-019-07200-3. Epub 2019 Oct 19.