Original ResearchFull Report: Basic and Translational—Alimentary TractDifferences in Alimentary Glucose Absorption and Intestinal Disposal of Blood Glucose After Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy
Section snippets
Materials and Methods
See Supplementary Material for detailed descriptions.
Roux-en-Y Gastric Bypass Quickly Induces Hypertrophy of the Alimentary Roux Limb
We studied early events after RYGB surgery either in a diet-induced obese rat model (Supplementary Text 1 and Supplementary Figures 1 and 2). As soon as 2 weeks after surgery, the alimentary RL was hypertrophic and displayed a dramatic increase in its diameter compared with that of the biliopancreatic limb (BPL) or with the corresponding jejunal segment of sham-operated rats (Figure 1A). The villus height and crypt depth of the RL were increased, leading to a thicker mucosa, and no modification
Discussion
In this study, using diet-induced obese rats, we directly compared the impact of 2 bariatric procedures on the glucose transport capacity of the intestine. We identified 2 distinct but rapid adaptations affecting intestinal morphology and glucose handling (Figure 7). In response to VSG, glucose transport capacity is reduced and density of cells secreting GLP1 is increased. In response to RYGB, the intestine became hyperplasic increasing de facto the number of GLP1-secreting cells but, more
Acknowledgments
The authors would like to thank the team of Nathalie Kapel at Department of Functional coprology, APHP for stool analyses; Prof D. Le Guludec, who is responsible for FRIM imaging platform and chief of the nuclear physic department; O. Thibaudeau and S. Ameur for help in histologic experiments; V. Descatoire for help in histologic analyses; L. Aline for technical help; and J. Le Beyec, H. Duboc and S. Ledoux for comments. Maude Le Gall thanks L. Arnaud for constant support.
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Conflicts of interest The authors disclose no conflicts.
Funding This work was supported by French Minister of Higher Education and Research, INSERM and University Paris Diderot.
Author names in bold designate shared co-first authorship.
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Authors share co-senior authorship.