Effects of sleeve gastrectomy with jejuno-jejunal or jejuno-ileal loop on glycolipid metabolism in diabetic rats

Figure 1 Sleeve gastrectomy (A), sleeve gastrectomy with jejuno-jejunal loop (B) and sleeve gastrectomy with jejuno-ileal loop (C). Sleeve gastrectomy (SG): The lesser curvature of the stomach is preserved and 70%-80% of the stomach is removed from the greater curvature; SG with jejuno-jejunal loop (SG-JJ): Based on SG surgery, a jejuno-jejunal side-by-side anastomosis was made between the jejunum 15 cm distal to the ligament of Treitz and 35 cm distal to the ligament of Treitz; SG with jejuno-ileal loop (SG-JI): Based on SG surgery, a jejuno-ileal side-by-side anastomosis was made between the jejunum 15 cm distal to the ligament of Treitz and the distal ileum 20 cm proximal to the ileocecal valve.

Figure 2 Area under the curve for the results of oral glucose tolerance test (A) and homeostasis model assessment of insulin resistance (B). Area under the curve for the results of oral glucose tolerance test (AUC_OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) were determined at baseline, and 2, 12 and 24 wk after surgery, and were analyzed by one-way ANOVA followed by Bonferroni post hoc comparison (^aP < 0.05 vs SHAM; ^bP < 0.05 vs SG). SHAM: Sham-operated; SG: Sleeve gastrectomy; SG-JJ: SG with jejuno-jejunal loop; SG-JI: SG with jejuno-ileal loop.

Figure 3 Fasting serum triglyceride (A), cholesterol (B), body weight (C) and calorie intake (D). Analysis was carried out by one-way ANOVA followed by Bonferroni post hoc comparison at baseline, and 2, 12 and 24 wk after surgery (^aP < 0.05 vs SHAM; ^bP < 0.05 vs SG; ^cP < 0.05 vs SG-JJ). SHAM: Sham-operated; SG: Sleeve gastrectomy; SG-JJ: SG with jejuno-jejunal loop; SG-JI: SG with jejuno-ileal loop.

Figure 4 Insulin secretion curves after gavage at baseline (A), and 2 wk (B), 12 wk (C) and 24 wk (D) after surgery. Analysis was carried out by mixed model ANOVA followed by Bonferroni post hoc comparison. The P value is shown in the rectangular frame. P < 0.05 was considered statistically significant. SHAM: Sham-operated; SG: Sleeve gastrectomy; SG-JJ: SG with jejuno-jejunal loop; SG-JI: SG with jejuno-ileal loop.

Figure 5 Glucagon-like peptide-1 secretion curves after gavage at baseline (A), 2 wk (B), 12 wk (C) and 24 wk (D) after surgery. Analysis was carried out by mixed model ANOVA followed by Bonferroni post hoc comparison. The P value is shown in the rectangular frame. P < 0.05 was considered statistically significant. GLP-1: Glucagon-like peptide-1; SHAM: Sham-operated; SG: Sleeve gastrectomy; SG-JJ: SG with jejuno-jejunal loop; SG-JI: SG with jejuno-ileal loop.

Figure 6 Fasting serum ghrelin at baseline, and 2, 12 and 24 wk after surgery. Analysis was carried out by one-way ANOVA followed by Bonferroni post hoc comparison. Sleeve gastrectomy (SG), SG with jejuno-jejunal loop (SG-JJ) and SG with jejuno-ileal loop (SG-JI) groups showed lower fasting serum ghrelin at all postoperative time points, and no difference in fasting serum ghrelin among the three groups was discovered during this study (^aP < 0.05 vs SHAM). SHAM: Sham-operated group.