Effect and mechanism of sleeve gastrectomy on obese rats with type 2 diabetes mellitus

doi:10.3877/cma.j.issn.1674-3946.2024.06.013

Abstract

Abstract:

Objective

To study the effect and possible mechanism of sleeve gastrectomy (SG) on obese rats with type 2 diabetes mellitus (T2DM).

Methods

A total of 60 rats were randomly divided into normal control group (group A, n=15), simple obesity group (group B, n=15), obesity group with type 2 diabetes mellitus (group C, n=15) and sleeve gastrectomy group (group D, n=15). The rats underwent corresponding modeling and intervention for 8 weeks, respectively. SPSS 22.0 statistical software was used for data analysis. Fasting blood glucose (FBG), insulin resistance index (HOMA-IR), area under the curve of glucose tolerance test (OGTT) (AUC), lipid metabolism indexes [total cholesterol (TC), triacylglycerol (TG)], inflammation indexes [C-reactive protein (CRP), interleukin-6 (IL-6)] and serum amylase (AMY) levels in rats The experimental data of glucose-regulated protein 78 (GRP78) and cysteine proteolytic enzyme 12 (Caspase-12) in pancreatic tissue were expressed by (). The multi-group comparison was performed by one-way ANOVA analysis, and the comparison between groups was performed by LSD test. P < 0.05 was considered statistically significant.

Results

Only 3 rats in group D died after operation, and the rest were successfully modeled. Before operation, the body weight of rats in groups B, C and D was significantly higher than that in group A (P < 0.05), and the FBG level and OGTTAUC value in groups C and D were significantly higher than those in groups A and B (P < 0.05). After 2 to 8 weeks, the body weight of group B was higher than that of group A (P < 0.05), and the body weight and FBG level of group D were lower than that of group C (P < 0.05). At 8 weeks after operation, the OGTT AUC and HOME-IR index of rats in group D were significantly lower than those in group C (P < 0.05). The levels of TG, CRP, IL-6 and AMY in group D were significantly lower than those in group C (all P < 0.05). Compared with group A, the islet cells of group B and group C were irregular and disordered, the cell boundaries were blurred, and there were empty vesicles in the interstitial of islets, indicating the presence of lipid deposition due to inflammatory infiltration. The pathological changes of group C were more serious than that of group B. The above pathological changes of rats in group D were less than those in group C. The protein expressions of GRP78 and Caspase-12 in group D were significantly lower than those in group C (P < 0.05).

Conclusion

SG surgery can reduce the body weight and blood glucose level in obese rats with T2DM model, improve glucose and lipid metabolism, reduce insulin resistance, and alleviate pancreatic injury, which may be related to inhibiting the activation of GRP78/Caspase-12 pathway.

Key words: Sleeve Gastrectomy, Obesity, Type 2 Diabetes Mellitus, Glycolipid Metabolism, Pancreatic Injury, GRP78/Caspase-12 Pathway

Lingkai Meng, Dayong Li, Ning Wang, Guiming Wang, Bingnan Zhang, Ruotong Li, Lifeng Pan. Effect and mechanism of sleeve gastrectomy on obese rats with type 2 diabetes mellitus[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(06): 638-642.

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Figures/Tables 7

References 19

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组别	只数	OGTT _AUC值		HOME-IR指数
组别	只数	术前	术后8周	HOME-IR指数
A组	15	1265.6±132.5	1249.5±128.7	1.9±0.5
B组	15	1274.4±129.7	1265.8±124.1	1.8±0.7
C组	15	3878.5±324.6^ab	3254.2±303.8^ab	8.2±3.6^ab
D组	15	3901.2±318.3^abc	1357.9±262.6^abc	1.5±0.7^c
F值		560.603	303.320	41.297
P值		<0.001	<0.001	<0.001

组别	只数	OGTT _AUC值		HOME-IR指数
组别	只数	术前	术后8周	HOME-IR指数
A组	15	1265.6±132.5	1249.5±128.7	1.9±0.5
B组	15	1274.4±129.7	1265.8±124.1	1.8±0.7
C组	15	3878.5±324.6^ab	3254.2±303.8^ab	8.2±3.6^ab
D组	15	3901.2±318.3^abc	1357.9±262.6^abc	1.5±0.7^c
F值		560.603	303.320	41.297
P值		<0.001	<0.001	<0.001

组别	只数	TC(mmol/L)	TG(mmol/L)	CRP(μg/ml)	IL-6(pg/mL)	AMY(ng/mL)
A组	15	3.2±1.4	2.8±1.1	1.8±0.3	39.5±11.6	0.7±0.2
B组	15	4.6±1.5^a	4.5±1.8^a	2.4±0.4^a	57.2±12.8^a	1.2±0.3^a
C组	15	2.5±0.9^ab	1.9±0.7^ab	2.8±0.3^ab	85.6±13.1^ab	2.1±0.4^ab
D组	15	2.2±0.6^ab	1.3±0.5^abc	2.2±0.2^ac	60.4±10.3^ac	1.0±0.3^ac
F值		11.591	20.113	26.393	37.003	56.508
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	只数	TC(mmol/L)	TG(mmol/L)	CRP(μg/ml)	IL-6(pg/mL)	AMY(ng/mL)
A组	15	3.2±1.4	2.8±1.1	1.8±0.3	39.5±11.6	0.7±0.2
B组	15	4.6±1.5^a	4.5±1.8^a	2.4±0.4^a	57.2±12.8^a	1.2±0.3^a
C组	15	2.5±0.9^ab	1.9±0.7^ab	2.8±0.3^ab	85.6±13.1^ab	2.1±0.4^ab
D组	15	2.2±0.6^ab	1.3±0.5^abc	2.2±0.2^ac	60.4±10.3^ac	1.0±0.3^ac
F值		11.591	20.113	26.393	37.003	56.508
P值		<0.001	<0.001	<0.001	<0.001	<0.001

项目	A组	B组	C组	D组	F值	P值
GRP78蛋白	0.26±0.02	0.71±0.17^a	2.54±0.25^ab	1.13±0.23^abc	414.100	<0.001
Caspase-12蛋白	0.31±0.04	0.84±0.13^a	1.83±0.20^ab	0.98±0.24^abc	217.199	<0.001

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