Document Detail


Ileal interposition improves glucose tolerance and insulin sensitivity in the obese Zucker rat.
MedLine Citation:
PMID:  20634437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hindgut hypothesis posits improvements in Type 2 diabetes after gastric bypass surgery are due to enhanced delivery of undigested nutrients to the ileum, which increase incretin production and insulin sensitivity. The present study investigates the effect of ileal interposition (IT), surgically relocating a segment of distal ileum to the proximal jejunum, on glucose tolerance, insulin sensitivity, and glucose transport in the obese Zucker rat. Two groups of obese Zucker rats were studied: IT and sham surgery ad libitum fed (controls). Changes in food intake, body weight and composition, glucose tolerance, insulin sensitivity and tissue glucose uptake, and insulin signaling as well as plasma concentrations of glucagon-like peptide-1 and glucose-dependent insulinotropic peptide were measured. The IT procedure did not significantly alter food intake, body weight, or composition. Obese Zucker rats demonstrated improved glucose tolerance 3 wk after IT compared with the control group (P < 0.05). Euglycemic, hyperinsulinemic clamp and 1-[(14)C]-2-deoxyglucose tracer studies indicate that IT improves whole body glucose disposal, insulin-stimulated glucose uptake, and the ratio of phospho- to total Akt (P < 0.01 vs. control) in striated muscle. After oral glucose, the plasma concentration of glucagon-like peptide-1 was increased, whereas GIP was decreased following IT. Enhanced nutrient delivery to the ileum after IT improves glucose tolerance, insulin sensitivity and muscle glucose uptake without altering food intake, body weight, or composition. These findings support the concept that anatomic and endocrine alterations in gut function play a role in the improvements in glucose homeostasis after the IT procedure.
Authors:
Derek M Culnan; Vance Albaugh; Mingjie Sun; Christopher J Lynch; Charles H Lang; Robert N Cooney
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-15
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  299     ISSN:  1522-1547     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-09-24     Revised Date:  2011-09-13    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G751-60     Citation Subset:  IM    
Affiliation:
Departments of Surgery, Pennsylvania State University College of Medicine, Hershey, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Glucose
Glucose Clamp Technique
Glucose Intolerance / metabolism*,  surgery
Glucose Tolerance Test
Ileum / anatomy & histology*,  physiology*,  surgery
Insulin Resistance / physiology*
Male
Obesity
Rats
Rats, Zucker
Weight Loss
Grant Support
ID/Acronym/Agency:
DK-062880/DK/NIDDK NIH HHS; GM-38032/GM/NIGMS NIH HHS; GM-55639/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose
Comments/Corrections

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