Expedited Biliopancreatic Juice Flow to the Distal Gut Benefits the Diabetes Control After Duodenal-Jejunal Bypass

Han, Huijian; Wang, Lei; Du, Hong; Jiang, Jianjun; Hu, Chunxiao; Liu, Shaozhuang; Zhang, Xiang; Li, Teng; Hu, Sanyuan

doi:10.1007/s11695-015-1633-7

Cited by 21 publications

(14 citation statements)

References 38 publications

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“…Expedited biliopancreatic juice flow to the distal gut was associated with increased GLP-1 secretion which may partly explain the metabolic benefits of duodenal-jejunal bypass (DJB) [ 112 ]. DJB-operated diabetic rats exhibited higher glucose-stimulated GLP-1 secretion than the duodenal-jejunal anastomosis (DJA) group postoperatively [ 112 ]. Overall, metabolic surgeries are effective in improving glucose metabolism and weight loss may in part be due to the enhanced GLP-1 levels.…”

Section: Glp-1 Levels and Duodenal-jejunal Bypassmentioning

confidence: 99%

Multiple Factors Related to the Secretion of Glucagon-Like Peptide-1

Wang

Liu²,

Chen

et al. 2015

International Journal of Endocrinology

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The glucagon-like peptide-1 is secreted by intestinal L cells in response to nutrient ingestion. It regulates the secretion and sensitivity of insulin while suppressing glucagon secretion and decreasing postprandial glucose levels. It also improves beta-cell proliferation and prevents beta-cell apoptosis induced by cytotoxic agents. Additionally, glucagon-like peptide-1 delays gastric emptying and suppresses appetite. The impaired secretion of glucagon-like peptide-1 has negative influence on diabetes, hyperlipidemia, and insulin resistance related diseases. Thus, glucagon-like peptide-1-based therapies (glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors) are now well accepted in the management of type 2 diabetes. The levels of glucagon-like peptide-1 are influenced by multiple factors including a variety of nutrients. The component of a meal acts as potent stimulants of glucagon-like peptide-1 secretion. The levels of its secretion change with the intake of different nutrients. Some drugs also have influence on GLP-1 secretion. Bariatric surgery may improve metabolism through the action on GLP-1 levels. In recent years, there has been a great interest in developing effective methods to regulate glucagon-like peptide-1 secretion. This review summarizes the literature on glucagon-like peptide-1 and related factors affecting its levels.

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Section: Glp-1 Levels and Duodenal-jejunal Bypassmentioning

confidence: 99%

Multiple Factors Related to the Secretion of Glucagon-Like Peptide-1

Wang

Liu²,

Chen

et al. 2015

International Journal of Endocrinology

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“…Single-anastomosis duodenal jejunal bypass (DJBsa) is similar to DJB but with a simplified reconstruction method (Torres, 2019). Moreover, DJB-sa did not alter the biliopancreatic diversion or accelerate biliopancreatic flow to the lower intestine (Han et al, 2015;Weng et al, 2017). Although it has been reported that the new biliopancreatic diversion might be an effective mechanism to improve the condition of T2DM after DJB (Dubourg et al, 2013;Weng et al, 2017), DJB-sa did not display this effect.…”

Section: Introductionmentioning

confidence: 99%

Single-Anastomosis Duodenal Jejunal Bypass Improve Glucose Metabolism by Regulating Gut Microbiota and Short-Chain Fatty Acids in Goto-Kakisaki Rats

Zhang

et al. 2020

Front. Microbiol.

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In recent years, bariatric surgery has emerged as a promising treatment for type 2 diabetes. Bariatric surgery is known to cause alterations in the relative abundance and composition of gut microbiota, which may lead to alterations in the levels of Short-Chain Fatty Acids (SCFAs) that are produced during fermentation by gut microbes. However, little is known about the mechanism of improved glucose metabolism mediated by gut microbiota following bariatric surgery. The aim of our study was to explore whether changes in gut microbiota and in fecal SCFA could be detected following singleanastomosis duodenal jejunal bypass (DJB-sa) surgery, a type of bariatric surgery, and whether these alterations might be related to the improvement of glucose metabolism. To this end, we performed DJB-sa or SHAM surgery on Goto-Kakisaki (GK) rats. We then compared the glucose metabolism as well as changes in gut microbiota and SCFAs levels between both groups. Our results showed that DJB-sa surgery was associated with a significant decrease in fasting blood glucose (FBG), intraperitoneal glucose tolerance test (IPGTT), and fasting serum insulin (FSI). And, DJB-sa led to a change in the composition of gut microbiota including an increase in the relative abundance of SCFA-producing bacteria (Bifidobacterium and Subdoligranulum). Moreover, the levels of six SCFAs in feces, as well as the intestinal expression of SCFA receptors including G-protein-coupled receptor 41 (GPR41), G-protein-coupled receptor 43 (GPR43), and G-protein-coupled receptor 109A (GPR109A), and the expression of Glucagon-like peptide-1 (GLP-1) displayed a significant increase following DJB-sa compared with the Sham group. Thus, the gut microbiota may contribute to the improvement of glucose metabolism in type 2 diabetes following DJB-sa. In conclusion, our study shows that DJB-sa improves glucose metabolism by modulating gut microbiota and by increasing short-chain fatty acid production.

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“…One interesting phenomenon observed after bariatric surgery is the increase of serum total bile acids. Actually, apart from the purely restrictive procedure, adjustable gastric banding (AGB) (Kohli et al, 2013a), it has been reported that all other types of bariatric surgery are associated with postsurgical increase of serum total bile acids (Steinert et al, 2013; Albaugh et al, 2015; Ferrannini et al, 2015; Han et al, 2015). And this phenomenon has raised concern about the relationships between bile acids and bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Role of Bile Acids in Bariatric Surgery

et al. 2019

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Bariatric surgery has been proved to be effective and sustainable in the long-term weight-loss and remission of metabolic disorders. However, the underlying mechanisms are still far from fully elucidated. After bariatric surgery, the gastrointestinal tract is manipulated, either anatomically or functionally, leading to changed bile acid metabolism. Accumulating evidence has shown that bile acids play a role in metabolic regulation as signaling molecules other than digestive juice. And most of the metabolism-beneficial effects are mediated through nuclear receptor FXR and membrane receptor TGR5, as well as reciprocal influence on gut microbiota. Bile diversion procedure is also performed on animals to recapitulate the benefits of bariatric surgery. It appears that bile acid alteration is an important component of bariatric surgery, and represents a promising target for the management of metabolic disorders.

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Expedited Biliopancreatic Juice Flow to the Distal Gut Benefits the Diabetes Control After Duodenal-Jejunal Bypass

Abstract: Expedited biliopancreatic juice flow to the distal gut was associated with augmented GLP-1 secretion and increased fasting serum TBA concentration, which may partly explain the metabolic benefits of DJB.

Cited by 21 publications

References 38 publications

Multiple Factors Related to the Secretion of Glucagon-Like Peptide-1

Multiple Factors Related to the Secretion of Glucagon-Like Peptide-1

Single-Anastomosis Duodenal Jejunal Bypass Improve Glucose Metabolism by Regulating Gut Microbiota and Short-Chain Fatty Acids in Goto-Kakisaki Rats

Role of Bile Acids in Bariatric Surgery

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