Foregut (foregut exclusions) and hindgut (rapid transit of nutrients to the distal intestine) theories are the most commonly used explanations for the metabolic improvements observed after metabolic surgeries. However, several procedures that do not comprise duodenal exclusions, such as sleeve with jejunojejunal bypass, ileal interposition, and transit bipartition and sleeve gastrectomy were found to have similar diabetes remission rates when compared with duodenal exclusion procedures, such as gastric bypass, biliopancreatic diversion with duodenal switch, and diverted sleeve with ileal interposition. Moreover, the complete exclusion of the proximal intestine could result in the malabsorption of several important micronutrients. This article reviews commonly performed procedures, with and without foregut exclusion, to better comprehend whether there is a critical need to include foregut exclusion in metabolic surgery.
PurposeThe mechanism in which bariatric surgery induces diabetes remission is still poorly understood. This study proposes Thioredoxin-interacting protein (TXNIP) as a possible factor for the anti-diabetic mechanism after sleeve gastrectomy (SG). Materials and Methods Plasma TXNIP level in obesity patients with diabetes (T2D, N = 20), obesity patients without diabetes (NDO, N = 20), and patients without obesity and diabetes (lean, N = 10) were assessed before surgery and at 1 and 12 months after SG. Results Preoperative TXNIP level was significantly higher in T2D (196.4 ± 76.0 pg/ml) and NDO (149.7 ± 94.1 pg/ml) patients when compared with lean patients (98.7 ± 22.7 pg/ml) (p-value < 0.05). At 1 month and 12 months postoperatively, the TXNIP levels were reduced significantly from the preoperative levels in the T2D and NDO patients (p-value < 0.05). Before surgery, a correlation between TXNIP and fasting blood glucose (FBG) (r 2 = 0.1585, p-value = 0.0109), HbA1C (r 2 = 0.2120, p-value = 0.0028), and insulin (r 2 = 0.1217, p-value = 0.0274) was observed. At 12 months after surgery, the reduction of TXNIP was also correlated with the degree of FBG (r 2 = 0.1038, p-value = 0.0426), HbA1C (r 2 = 0.2459, p-value = 0.0011), and insulin (r 2 = 0.1365, p-value = 0.0190) reduction. Conclusion Plasma TXNIP level is elevated in obesity patients with/without diabetes. SG resulted in a significant reduction of plasma TXNIP level which is correlated with the degree of FBG, HbA1C, and insulin reduction. Regulation of TXNIP could be part of the mechanism of diabetes remission after bariatric surgery.
Reduced graphene oxide (rGO) supercapacitors usually featured poor capacitive characteristics. As a simple, nonclassical redox molecule, amino hydroquinone dimethylether was firstly coupled with rGO, which boosted rGO capacitance to 523...
Purpose. The purpose of this study was to investigate the effect of bariatric surgery on pancreatic thioredoxin-interacting protein (TXNIP) and insulin expression levels. The research question is does bariatric surgery induce changes in the pancreatic TXNIP level, given that TXNIP has been proposed as a key glucose control factor? Methods. Using nondiabetic and diabetic rats, we investigated whether our streptozotocin-induced diabetic rat models exhibited changes in pancreatic TXNIP regulation. Following this confirmation, we randomly divided the diabetic rats into the following three groups: the gastric bypass group (
n
=
16
), pair-fed group (
n
=
10
), and sham group (
n
=
10
). Preoperatively and 3 weeks postoperatively, all the rats underwent an oral glucose tolerance test, insulin tolerance test, and blood sampling procedures for hormonal analysis. Results. The TXNIP messenger ribonucleic acid (mRNA) and protein expression levels were significantly lower in the gastric bypass group than in the other groups. Regarding the gastric bypass group, the pancreatic mRNA expression levels of microRNA-204 (miR-204) and MafA were significantly lower and higher, respectively, than in the other groups. Furthermore, the levels of pancreatic insulin expression at the mRNA and protein levels were also significantly higher in the gastric bypass group than in the other groups. Conclusion. Bariatric surgery significantly improved glucose control and regulated the pancreatic insulin production pathways of TXNIP, miR-204, and MafA. The regulation of TXNIP, miR-204, and MafA might play an important role in the mechanism of diabetes remission following bariatric surgery.
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