An endoluminal sleeve induces substantial weight loss and normalizes glucose homeostasis in rats with diet-induced obesity.
An endoluminal sleeve induces substantial weight loss and normalizes glucose homeostasis in rats with diet-induced obesity.
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DOI：
10.1038/oby.2008.502
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发表时间：
2008-12
期刊：
影响因子：
6.9
通讯作者：
Kaplan, Lee M.
中科院分区：
文献类型：
--
作者：
Aguirre, Vincent;Stylopoulos, Nicholas;Grinbaum, Ronit;Kaplan, Lee M.
为了研究两种外科肠道操作（近端肠从消化道流中排除和空肠暴露于部分消化的营养物质）对体重调节和代谢的贡献，我们开发了一种研究器械（腔内袖套（ELS））的大鼠模型。ELS是一种设计用于腔内植入的10 cm、营养物不可渗透的柔性管。将ELS装置通过手术植入饮食诱导肥胖大鼠的十二指肠球部。随后评估了体重、食物摄入量、粪便热量和葡萄糖稳态。与假手术（SO）对照组相比，植入ELS的大鼠体重减轻20%。ELS处理的动物消耗的平均27%千卡/天比SO少，没有证据表明吸收不良。口服和腹腔给药后，ELS治疗可改善空腹血糖和葡萄糖耐量。ELS治疗改善了胰岛素敏感性，如通过降低空腹和葡萄糖刺激的胰岛素水平所证明的，并通过计算胰岛素抵抗的稳态模型评估所证实的。这些数据表明，通过ELS将部分消化的营养物质递送到空肠的近端肠的选择性旁路模拟了RYGB对体重和葡萄糖代谢的许多影响。因此，ELS植入可能是治疗肥胖和糖尿病的有效方法。由于ELS装置适合于内窥镜放置，它可以为选定的肥胖及其代谢并发症患者提供一种有价值的替代更具侵入性的手术方法。
To investigate the contributions of two surgical gut manipulations – exclusion of the proximal intestine from alimentary flow and exposure of the jejunum to partially digested nutrients – to body weight regulation and metabolism, we have developed a rat model of an investigational device, the endoluminal sleeve (ELS). The ELS is a 10 cm, nutrient-impermeable, flexible tube designed for endoluminal implantation. ELS devices were surgically implanted in the duodenal bulb of rats with diet-induced obesity. Body weight, food intake, stool caloric content, and glucose homeostasis were subsequently evaluated. ELS-implanted rats demonstrated a 20% reduction of body weight compared to sham-operated (SO) controls. ELS-treated animals consumed an average of 27% fewer kcal/day than SO, and there was no evidence of malabsorption. ELS treatment improved fasting glycemia and glucose tolerance after oral and intraperitoneal administration. ELS treatment improved insulin sensitivity, as demonstrated by decreased fasting and glucose-stimulated insulin levels and confirmed by calculation of homeostasis model assessment of insulin resistance. These data suggest that selective bypass of the proximal intestine with delivery of partially digested nutrients to the jejunum by ELS mimics many of the effects of RYGB on body weight and glucose metabolism. Thus, ELS implantation may be an effective treatment for obesity and diabetes. Since the ELS device is amenable to endoscopic placement, it may offer a valuable alternative to more invasive surgical approaches in selected patients with obesity and its metabolic complications.
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影响因子：
3.1
作者：
Rodriguez-Grunert, Leonardo;Neto, Manoel Passos Galvao;Tarnoff, Michael
通讯作者：
Tarnoff, Michael
影响因子：
3.7
作者：
Kaplan, LM
通讯作者：
Kaplan, LM
影响因子：
3.8
作者：
Patriti, Alberto;Aisa, Maria Cristina;Donini, Annibale
通讯作者：
Donini, Annibale
影响因子：
1.5
作者：
Gersin, Keith S.;Keller, Jennifer E.;Heniford, B. Todd
通讯作者：
Heniford, B. Todd
DOI：
10.1152/ajpregu.00171.2007
发表时间：
2007-10-01
影响因子：
2.8
作者：
Guijarro, Ana;Suzuki, Susumu;Meguid, Michael M.
通讯作者：
Meguid, Michael M.