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128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

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Early control of glucose homeostasis after ileal transposition in obese diabetic Zucker rats

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  • Jodok Grüneberger - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Goran Marjanovic - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Tobias Fritz - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Cheng Zhou - Wuhan Number 1 Hospital , Hankou
  • Simon Küsters - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Birte Kulemann - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Philipp Holzner - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Oliva Sick - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Ulrich Theodor Hopt - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg
  • Woiciech Konrad Karcz - Universitätsklinik Freiburg, Allgemein- und Viszeralchirurgie, Freiburg

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch814

doi: 10.3205/11dgch814, urn:nbn:de:0183-11dgch8142

Veröffentlicht: 20. Mai 2011

© 2011 Grüneberger et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

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Introduction: Surgical therapy of type 2 diabetes mellitus in obese patients (BMI>35kg/m2) is shown to be effective using bariatric procedures as gastric bypass or biliopancreatic diversion. We studied the effect of an ileal transposition (IT) on glucose homeostasis and gut hormones in obese diabetic Zucker rats.

Materials and methods: Twenty obese diabetic Zucker rats (10-12 weeks old) were randomly assigned to two groups (n=10): In the IT group, 50% of the distal part of the ileum were transposed directly after the ligament of Treitz. In the control group (Co) three end-to-end small bowel anastomoses in analogous position were performed without ileal transposition. Rats were observed for three weeks postoperatively. Body weight, oral glucose tolerance test (OGTT), insulin, glucagon-like peptide-1 (GLP-1) and polypeptide YY (PYY) levels were measured on different times. Statistical analysis was performed using SPSS (significance for p<0.05).

Results: All animals lost an equivalent percentage of body weight until the 5th POD. In the following two weeks the mean body weight regain was significantly lower (41g IT vs. 57g Co) in IT group. Two weeks after the operation fasting blood glucose was similar in IT and Co group (74mg/dl vs. 71mg/dl); but during the OGTT, IT rats showed a faster increase and a faster decrease of blood glucose with a lower peak than sham operated rats. Preoperative hormone levels (insulin, GLP-1, PYY) were comparable. During observational time insulin levels significantly decreased in IT rats and remained stable in Co rats. GLP-1 and PYY levels significantly increased in IT rats and remained stable in Co rats.

Conclusion: Ileal transposition of 50% of the distal part of the ileum has a significant impact on glucose homeostasis in diabetic animals, decreasing the insulin level and increasing the levels of PYY and GLP-1. Proving these results in humans, IT may be offered as one of the preferred surgical options for patients with metabolic syndrome.