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Is the jejunum the fulcrum of glucose metabolism?
  1. Jose Manuel Fernández-Real1,2,3,
  2. Jordi Mayneris-Perxachs4
  1. 1 Service of Diabetes, Endocrinology and Nutrition, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Catalunya, Spain
  2. 2 Department of Medical Sciences, Faculty of Medicine. University of Girona, Girona, Catalunya, Spain
  3. 3 CIBER Pathophysiology of Obesity and Nutrition. Instituto de Salud Carlos III, Madrid, Spain
  4. 4 Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona Dr Josep Trueta and Hospital Dr Josep Trueta, Girona, Catalunya, Spain
  1. Correspondence to Dr Jose Manuel Fernández-Real, Endocrinology, Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Catalunya, Spain; jmfreal{at}

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Jejunum is derived from the Latin word jējūnus, from modern Latin noun use of Latin ‘ieiunum’, neuter of ieiunus ‘empty’ and also with the meaning of ‘fasting’. The jejunum is typically found empty during dissections, perhaps because it would tend to drain in a body laid on its back and is void of food following death (‘fasting’), due to its intensive peristaltic activity relative to the duodenum and ileum. In modern Italian (digiuno), Catalan (dejuni) and Galician (xexún), fasting is still named using similar words.

Since the observation by Rubino et al in 2004 that variations in circulating hormone levels occurred early after bariatric surgery in parallel to improvement of glucose metabolism before substantial weight modifications,1 the search for the factors responsible for these effects after bariatric surgery has been intensively pursued.

The surface of the intestine is critical in the rate of nutrition absorption. Small bowel length (SBL) has been claimed to determine the caloric absorptive capacity. Some authors have described a positive and statistically significant correlation between the Total SBL (TSBL) and both weight (p=0.01) and height (p<0.001) but not with body mass index (BMI) of the subjects.2 Other authors found that TSBL was positively linked to the weight of the subjects but not to height. …

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  • Contributors Both authors equally conceived, composed, reviewed and finalised the submitted articles.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

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