ObjectiveTo investigate the effect and mechanism of sleeve gastrectomy (SG) on reducing blood glucose level. MethodsThirty GK rats were randomly divided into SG group, sham operation (SO) group, pair-fed (PF) group, and blank control (BC) group. The changes of weight, fasting blood glucose, glucose tolerance (oral glucose tolerance test, OGTT), insulin tolerance (insulin tolerance test, ITT), plasma insulin, ghrelin, and glucagon like peptide-1 (GLP-1) were monitored before and 24 weeks after operation respectively. ResultsFrom the 4th week after operation, weight gain in SG group and PF group began to decrease significantly compared with SO group (Plt;0.01). From the 2nd week after operation, fasting blood glucose level in SG group was lower than that in SO, PF, and BC groups (Plt;005), and the glucose tolerance in SG group obviously improved compared with preoperation and the other 3 groups (Plt;0.01). On the 6th week after operation, the insulin sensitivity in SG group obviously improved compared with SO group (Plt;0.05, Plt;0.01). There was no significant difference of insulin level between SG group and SO group (Pgt;0.05), ghrelin level significantly decreased (Plt;0.01) while GLP-1 level significantly increased (Plt;0.01) in SG group compared with SO group during 2-24 weeks after operation. ConclusionsThe effect of SG on reducing blood glucose is definite. SG can directly lower blood glucose independent with weight loss. Postoperative decreased ghrelin level and increased GLP-1 level may be its primary mechanism.
ObjectiveTo explore a surgery of effective weight loss concentrating on gut hormone release. MethodsWistar rats were fed with high-fat diet for inducing obesity and which randomly divided into sleeve gastrectomy plus decent jejunoileal bypass (SJB) group (n=12), sleeve gastrectomy (SG) group (n=12), and sham operation (SO) group (n=11), the body weight reduction, food intake, plasma ghrelin level, and glucagon like peptide-1 (GLP-1) level were compared among three groups. ResultsThere were no differences of the body weight and food intake before operation among three groups (Pgt;0.05). Compared with the SO group, the body weight descended and the food intake decreased obviously on 1-8 weeks after operation in the SJB group (Plt;0.05), the body weight of rats on 1-8 weeks after operation in the SJB group significantly descended as compared with the SG group (Plt;0.05), and the food intake of rats on week 3, 6, 7, and 8 in the SJB group signicantly decreased as compared with the SG group (Plt;0.05). There were no differences of the levels of the plasma ghrelin and GLP-1 before operation among three groups (Pgt;0.05). Compared with SO group, the plasma ghrelin level decreased and the GLP-1 level increased in the SJB group and the SG group, meanwhile the SJB group significantly decreased level of plasma ghrelin and elevated level of plasma GLP-1 as compared with the SG group on week 8 after operation(Plt;0.05). ConclusionThe data demonstrate that SJB could represent an effective way of losing weight by interfering with food intake and obesity related hormone levels.
ObjectiveTo investigate the possible mechanism of the improvement of type 2 diabetes mellitus with insulin resistance of skeletal muscles after Roux-en-Y gastric bypass surgery (RYGB). MethodsThirty GK rats were randomly divided into GK-RYGB group, sham operation group (GK-SO group), and control group (GK-control group); in addition, 10 Wistar rats served as normal control group.On day 28, the animals were sacrificed.The ghrelin concen-tration and PI3Kp85α, Akt/PKB, and GLUT4 levels were measured by ELISA, Western blot, and real-time PCR me-thods, respectively. Results①Compared with the GK-SO group and GK-control group, the plasma ghrelin levels were significantly increased in the normal control group (P < 0.01) and GK-RYGB group (P < 0.01).②Compared with the GK-SO group and GK-control group, p-/t-PI3Kp85α, p-/t-Akt/PKB, and m-/t-GLUT4 proteins were significantly incre-ased in the normal control group (P < 0.01, P < 0.05, and P < 0.01, respectively) and GK-RYGB group (P < 0.01, P < 0.05, and P < 0.01, respectively).③Compared with the GK-SO group and GK-control group, PI3Kp85α, Akt, and GLUT4 mRNA were significantly increased in the normal control group (P < 0.01, P < 0.05, and P < 0.05, respectively) and GK-RYGB group (P < 0.01, P < 0.05, and P < 0.05, respectively). ConclusionRYGB could elevate the ghrelin level obviously and upregulate PI3Kp85α, Akt/PKB, and GLUT4 levels and thus improve the insulin resistance of skeletal muscles of rats with T2DM.
ObjectiveTo investigate the correlations of preoperative peripheral blood ghrelin levels and the albumin (ALB) / body mass index (BMI) ratio with the risk and severity of postoperative complications in gastric cancer. MethodsThe patients who underwent radical gastrectomy for gastric cancer at the 908th Hospital of the Joint Logistic Support Force of the People’s Liberation Army of China from September 2021 to June 2023 were enrolled. The incidence of postoperative complications during hospitalization was analyzed. Univariate and multivariate logistic regression analyses was used to analyze the effects of preoperative peripheral blood ghrelin levels and the ALB/BMI ratio on the risk of postoperative complications in gastric cancer. The predictive value of preoperative peripheral blood ghrelin levels, the ALB/BMI ratio, and their combination for postoperative complications in gastric cancer was evaluated using receiver operating characteristic (ROC) curves. Spearman correlation analysis was performed to analyze the correlation between preoperative peripheral blood ghrelin levels or the ALB/BMI ratio and the Clavien-Dindo grade of postoperative complications in gastric cancer. ResultsA total of 294 patients undergoing radical gastrectomy for gastric cancer were enrolled in this study, among whom 56 developed postoperative complications, with an overall complication rate of 19.05%. Univariate analysis revealed that age, preoperative comorbidities, combined organ resection, preoperative peripheral blood ghrelin levels, and ALB/BMI ratio were associated with postoperative complications following radical gastrectomy for gastric cancer (both P<0.05). Multivariate logistic regression analysis showed that, after adjusting for age, preoperative comorbidities, and combined organ resection, elevated ghrelin levels (OR=0.471, P<0.001) and increased ALB/BMI ratio (OR=0.454, P<0.001) remained independent protective factors against postoperative complications. The areas under the ROC curves (AUC) for preoperative peripheral blood ghrelin levels alone, the ALB/BMI ratio alone, and their combination in predicting postoperative complications in gastric cancer were 0.734, 0.749, and 0.864, respectively (all P<0.001). The DeLong test showed that the AUC of the combined prediction model was significantly higher than that of ghrelin levels alone and the ALB/BMI ratio alone (Z=2.985, P=0.003; Z=2.627, P=0.009). Spearman correlation analysis revealed that preoperative peripheral blood ghrelin levels and ALB/BMI ratio were negatively correlated with the severity of postoperative complications in gastric cancer (rs=–0.647, P<0.001; rs=–0.670, P<0.001). ConclusionsThe results indicate that preoperative peripheral blood ghrelin levels and ALB/BMI ratio of gastric cancer are related to the risk and severity of postoperative complications. The combined detection of the two has a high predictive value for postoperative complications of gastric cancer, which can provide a reference for preoperative prediction of the risk and severity of complications, but the research results still need to be further demonstrated by a prospective multi-center study.