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sleeve gastrectomy ameliorates endothelial function and prevents lung cancer by normalizing endothelin-1 axis in obese and diabetic rats

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World Journal of Gastroenterology 2020年第20期26卷 2599-2617页

作者： Rexiati Ruze Ya-Cheng Xiong Jian-Wen Li Ming-Wei Zhong Qian Xu Zhi-Bo Yan Jian-Kang Zhu Yu-Gang Cheng San-Yuan Hu Guang-Yong Zhang Department of General Surgery Shandong Provincial Qianfoshan HospitalShandong UniversityJinan 250014Shandong ProvinceChina Department of General Surgery Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China Department of General Surgery The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina Department of General Surgery Qilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina

BACKGROUND Previous evidence has implied that obesity is an independent risk factor for developing *** closely related to obesity,type 2 diabetes mellitus provides a suitable environment for the formation and metastasis of tumors through multiple *** bariatric surgeries are effective in preventing and lowering the risk of various types of cancer,the underlying mechanisms of this effect are not clearly *** To uncover the role and effect of sleeve gastrectomy(SG)in preventing lung cancer in obese and diabetic *** SG was performed on obese and diabetic Wistar rats,and the postoperative transcriptional and translational alterations of the endothelin-1(ET-1)axis in the lungs were compared to sham-operated obese and diabetic rats and age-matched healthy controls to assess the improvements in endothelial function and risk of developing lung cancer at the postoperative 4 th,8 th,and 12 th *** risk wasalso evaluated using nuclear phosphorylation of H2 A histone family member X as a marker of DNA damage(double-strand break).RESULTS Compared to obese and diabetic sham-operated rats,SG brought a significant reduction to body weight,food intake,and fasting blood glucose while improving oral glucose tolerance and insulin *** addition,ameliorated levels of gene and protein expression in the ET-1 axis as well as reduced DNA damage indicated improved endothelial function and a lower risk of developing lung cancer after the *** Apart from eliminating metabolic disorders,SG improves endothelial function and plays a protective role in preventing lung cancer via normalized ET-1 axis and reduced DNA damage.

关键词： sleeve gastrectomy Lung cancer Endothelin-1 axis Endothelial dysfunction DNA damage Obesity

Changes of Ghrelin/GOAT axis and m TOR pathway in the hypothalamus after sleeve gastrectomy in obese type-2 diabetes rats

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World Journal of Gastroenterology 2017年第34期23卷 6231-6241页

作者： Qiang Wang Wei Tang Wen-Sheng Rao Xin Song Cheng-Xiang Shan Wei Zhang Department of General Surgery Changzheng HospitalSecond Military Medical University Department of Surgery University of Tokyo Hospital

AIM To examine the changes of the ghrelin/ghrelin O-acyltransferase(GOAT) axis and the mammalian target of rapamycin(m TOR) pathway in the hypothalamus after sleeve *** A total of 30 obese type-2 diabetes Sprague-Dawley(SD) rats, 6 wk of age, fed with high-sugar and highfat fodder for 2 mo plus intraperitoneal injection of streptozotocin were randomly divided into three groups: non-operation group(S0 group, n = 10), sham operation group(Sh group, n = 10) and sleeve gastrectomy group(SG group, n = 10). Data of body mass, food intake, oral glucose tolerance test(OGTT), acylated ghrelin(AG) and total ghrelin(TG) were collected and measured at the first day(when the rats were 6 wk old), preoperative day 3 and postoperative week 8. The m RNA expression of preproghrelin, GOAT and neuropeptide Y(NPY), and protein expression of ghrelin, GOAT, GHSR and the m TOR pathway(p-Akt, p-m TOR and p-S6) were measured in the *** SG can significantly improve metabolic symptoms by reducing body mass and food intake. The obese rats showed lower serum TG levels and no change in AG, but the ratio of AG/TG was increased. When compared with the S0 and Sh groups, the SG group showed decreased TG(1482.03 ± 26.55, 1481.49 ± 23.30 and 1206.63 ± 52.02 ng/L, respectively, P 0.05). As a result, the ratio of AG/TG further increased in the SG group(0.103 ± 0.009, 0.105 ± 0.013 and 0.12 ± 0.016, respectively, P 0.05) in the hypothalamus. The protein levels of p-Akt, p-m TOR and p-S6 were higher in the SG group, which indicated that the hypothalamic m TOR pathway was activated after SG at the postoperative week 8. CONCLU

关键词： Ghrelin Ghrelin O-acyltransferase Type-2 Diabetes Hypothalamus Obesity sleeve gastrectomy Mammalian target of rapamycin

Laparoscopic sleeve gastrectomy for morbid obesity

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World Journal of Gastroenterology 2008年第6期14卷 821-827页

作者： Antonio Iannelli Raffaella Dainese Thierry Piche Enrico Facchiano Jean Gugenheim Service de Chirurgie Digestive et Centre de Transplantation Hépatique. Ple Digestif du CHU de Nice Université de Nice-Sophia-Antipolis Faculté de Médecine Nice F-06107 France Raffaella Dainese Thierry Piche Gastroenterology Department and Functional Unit Ple Digestif du CHU de Nice Centre Hospitalier Universitaire de Nice Ple Digestif Nice F-06202 France

The incidence of obesity is steadily rising, and it has been estimated that 40% of the US population will be obese by the year 2025 if the current trend continues. In recent years there has been renewed interest in the surgical treatment of morbid obesity in concomitance with the epidemic of obesity. Bariatric surgery proved effective in providing weight loss of large magnitude, correction of comorbidities and excellent short-term and long-term outcomes, decreasing overall mortality and providing a marked survival advantage. The Laparoscopic sleeve gastrectomy (LSG) has increased in popularity and is currently very "trendy" among laparoscopic surgeons involved in bariatric surgery. As LSG proved to be effective in achieving considerable weight loss in the short-term, it has been proposed by some as a sole bariatric procedure. This editorial focuses on the particular advantages of LSG in the treatment of morbid obesity.

关键词： Obesity Bbariatric surgery sleeve gastrectomy Ghrelin Weight loss

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy:Familial aggregation of obesity

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World Journal of Gastroenterology 2024年第13期30卷 1887-1898页

作者： Ze-Yu Wang Yun-Fei Qu Tian-Ming Yu Zeng-Lin Liu Yu-Gang Cheng Ming-Wei Zhong San-Yuan Hu Department of General Surgery The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan HospitalJinan 250000Shandong ProvinceChina Department of Postgraduate Shandong First Medical University and Shandong Academy of Medical SciencesJinan 250000Shandong ProvinceChina Department of General Surgery Shandong Provincial Qianfoshan HospitalCheeloo College of Medicine Shandong UniversityJinan 250000Shandong ProvinceChina State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine Lunan Pharmaceutical Group Co.Ltd.Linyi 276005Shandong ProvinceChina

BACKGROUND Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy(SG)between patients with familial aggregation of obesity(FAO)and patients with sporadic obesity(SO)have not been *** To explore the impact of SG on weight loss and the alleviation of obesity-related comorbidities in individuals with *** A total of 193 patients with obesity who underwent SG were *** with FAO/SO were matched 1:1 by propensity score matching and were categorized into 4 groups based on the number of first-degree relatives with obesity(1 SO vs 1FAO,2SO vs 2FAO).The baseline characteristics,weight loss outcomes,prevalence of obesity-related comorbidities and incidence of major surgeryrelated complications were compared between *** We defined FAO as the presence of two or more first-degree relatives with *** with FAO did not initially show significant differences in baseline data,short-term postoperative weight loss,or obesity-related comorbidities when compared to patients with SO ***,distinctions between the two groups became evident at the two-year mark,with statistically significant differences in both percentage of total weight loss(P=0.006)and percentage of excess weight loss(P<0.001).The FAO group exhibited weaker remission of type 2 diabetes mellitus(T2DM)(P=0.031),hyperlipidemia(P=0.012),and non-alcoholic fatty liver disease(NAFLD)(P=0.003)as well as a lower incidence of acid reflux(P=0.038).CONCLUSION FAO patients is associated with decreased mid-to-long-term weight loss outcomes;the alleviation of T2DM,hyperlipidemia and NAFLD;and decreased incidence of acid reflux postoperatively.

关键词： Obesity Bariatric surgery sleeve gastrectomy Family history Weight loss

Effects of sleeve gastrectomy plus trunk vagotomy compared with sleeve gastrectomy on glucose metabolism in diabetic rats

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World Journal of Gastroenterology 2017年第18期23卷 3269-3278页

作者： Teng Liu Ming-Wei Zhong Yi Liu Xin Huang Yu-Gang Cheng Ke-Xin Wang Shao-Zhuang Liu San-Yuan Hu Department of General Surgery Qilu Hospital of Shandong University Health and Family Planning Commission of Shandong Provincial Medical Guidance Center

AIM To investigate the effects of sleeve gastrectomy plus trunk vagotomy(SGTV) compared with sleeve gastrectomy(SG) in a diabetic rat *** SGTV, SG, TV and Sham operations were performed on rats with diabetes induced by high-fat diet and streptozotocin. Body weight, food intake, oral glucose tolerance test, homeostasis model assessment of insulin resistance(HOMA-IR), hepatic insulin signaling(IR, IRS1, IRS2, PI3 K and AKT), oral glucose stimulatedinsulin secretion, GLP-1 and ghrelin were compared at various postoperative *** Both SG and SGTV resulted in better glucose tolerance, lower HOMA-IR, up-regulated hepatic insulin signaling, higher levels of oral glucose-stimulated insulin secretion, higher postprandial GLP-1 and lower fasting ghrelin levels than the TV and Sham groups. No significant differences were observed between the SG and SGTV groups. In addition, no significant differences were found between the TV and Sham groups in terms of glucose tolerance, HOMA-IR, hepatic insulin signaling, oral glucose-stimulated insulin secretion, postprandial GLP-1 and fasting ghrelin levels. No differences in body weight and food intake were noted between the four *** SGTV is feasible for diabetes control and is independent of weight loss. However, SGTV did not result in a better improvement in diabetes than SG alone.

关键词： sleeve gastrectomy Trunk vagotomy Glucose metabolism GLP-1 Ghrelin

Fibroblast growth factor 15,induced by elevated bile acids,mediates the improvement of hepatic glucose metabolism after sleeve gastrectomy

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World Journal of Gastroenterology 2023年第21期29卷 3280-3291页

作者： Meng Wei Wei-Bo Cao Ru-Dong Zhao Dan-Ping Sun Yi-Ze Liang Ya-Di Huang Ze-Wei Cheng JunOuyang Wen-Shuo Yang Wen-Bin Yu Department of General Surgery Qilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina

BACKGROUND Fibroblast growth factor(FGF)15/19,which is expressed in and secreted from the distal ileum,can regulate hepatic glucose metabolism in an endocrine *** levels of both bile acids(BAs)and FGF15/19 are elevated after bariatric ***,it is unclear whether the increase in FGF15/19 is induced by ***,it remains to be understood whether FGF15/19 elevations contribute to improvements in hepatic glucose metabolism after bariatric *** To investigate the mechanism of improvement of hepatic glucose metabolism by elevated BAs after sleeve gastrectomy(SG).METHODS By calculating and comparing the changes of body weight after SG with SHAM group,we examined the weight-loss effect of *** oral glucose tolerance test(OGTT)test and area under the curve of OGTT curves were used to assess the anti-diabetic effects of *** detecting the glycogen content,expression and activity of glycogen synthase as well as the glucose-6-phosphatase(G6Pase)and phosphoenolpyruvate carboxykinase(Pepck),we evaluated the hepatic glycogen content and gluconeogenesis *** examined the levels of total BA(TBA)together with the farnesoid X receptor(FXR)-agonistic BA subspecies in systemic serum and portal vein at week 12 *** the histological expression of ileal FXR and FGF15 and hepatic FGF receptor 4(FGFR4)with its corresponding signal pathways involved in glucose metabolism were *** After surgery,food intake and body weight gain of SG group was decreased compare with the SHAM *** hepatic glycogen content and glycogen synthase activity was significantly stimulated after SG,while the expression of the key enzyme for hepatic gluconeogenesis:G6Pase and Pepck,were *** levels in serum and portal vein were both elevated after SG,the FXR-agonistic BA subspecies:Chenodeoxycholic acid(CDCA),lithocholic acid(LCA)in serum and CDCA,DCA,LCA in portal vein were all higher in SG group than that in SHAM ***,the ileal

关键词： sleeve gastrectomy Fibroblast growth factor 15 Bile acids Hepatic glucose metabolism Type 2 diabetes mellitus

Effects of sleeve gastrectomy Surgery with Modified Jejunoileal Bypass on Body Weight, Food Intake and Metabolic Hormone Levels of Rats

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2011年第6期31卷 784-788页

作者：严玲玲朱占永吴丹周启星吴毅平 Department of Plastic Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Department of Plastic Surgery Wuhan Medical Care Center for Women and Children Department of Plastic Surgery Renmin Hospital of Wuhan University Department of Plastic Surgery Hubei Medical Care Center for Women and Children

This study examined the effects of a combined surgery of sleeve gastrectomy （SG） and modified jejunoileal bypass （JIB） on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 （GLP-1） and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol： SG-JIB （n=12）, SG （n=12）, JIB （n=12） and sham surgery groups （n-10）. In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum （25 cm from the ligament of Treitz） to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.

关键词： sleeve gastrectomy modified jejunoileal bypass body weight food intake glucagon-like peptide- 1 ghrelin

Effect of oligofructose on resistance to postoperative high-fat diet-induced damage of metabolism in diabetic rats after sleeve gastrectomy

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World Journal of Diabetes 2021年第4期12卷 453-465页

作者： Ming-Wei Zhong Yue Li Yu-Gang Cheng Qiao-Ran Liu San-Yuan Hu Guang-Yong Zhang Department of General Surgery The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan HospitalJinan 250014Shandong ProvinceChina Key Laboratory of Metabolism and Gastrointestinal Tumor The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina Key Laboratory of Laparoscopic Technology The First Affiliated Hospital of Shandong First Medical UniversityShandong Medicine and Health Key Laboratory of General SurgeryJinan 250014Shandong ProvinceChina Department of General Surgery Shandong Qianfoshan HospitalCheeloo College of MedicineShandong UniversityJinan 250014Shandong ProvinceChina

BACKGROUND sleeve gastrectomy(SG) can induce prominent remission of type 2 diabetes ***,the long-term remission rate of diabetes usually decreases over *** has been verified to modulate host *** aim of this study was to explore the protective effect of oligofructose on high-fat diet(HFD)-induced metabolic dysfunction after *** To study the effect and mechanism of oligofructose on diabetic remission in diabetic rats after *** SG and SHAM operation were performed on diabetes rats induced with an HFD,nicotinamide,and low-dose *** the rats in the SHAM and SG groups were continuously provided with the HFD,and the rats in sleeve gastrectomy-oligofructose group were provided with a specific HFD containing10% *** weight,calorie intake,oral glucose tolerance test,homeostasis model assessment of insulin resistance,lipid profile,serum insulin,glucagon-like peptide 1(GLP-1),total bile acids,lipopolysaccharide(LPS),and colonic microbiota levels were determined and compared at the designated time *** statistical analyses were performed using Statistic Package for Social Science version 19.0(IBM,United States),and the statistically significant difference was considered at P <*** At 2 wk after surgery,rats that underwent SG exhibited improved indexes of glucose and lipid *** with the SG group,the rats from SGoligofructose group exhibited better parameters of glucose and lipid metabolism,lower body weight(526.86±21.51 vs 469.25±21.84,P <0.001),calorie intake(152.14±9.48 vs 129.63±8.99,P <0.001),homeostasis model assessment of insulin resistance(4.32±0.57 vs 3.46±0.52,P <0.05),and LPS levels(0.19±0.01 vs 0.16±0.01,P <0.05),and higher levels of insulin(1.17±0.17 vs 1.58±0.16,P <0.001) and GLP-1(12.39±1.67 vs 14.94±1.86,P <0.001),and relative abundances of Bifidobacterium(0.0034±0.0014 vs 0.0343±0.0064,P <0.001),Lactobacillus(0.0161±0.0037 vs 0.0357±0.0047,P <0.001),and Akker

关键词： sleeve gastrectomy Oligofructose Diabetes Gut microbiota Lipopolysaccharide Glucagon-like peptide 1

Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity:A prospective study

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World Journal of Gastrointestinal Surgery 2017年第4期9卷 109-117页

作者： Carlos Hoyuela Department of General and Digestive Surgery Hospital PlatóUniversitat Autònoma de Barcelona08006 BarcelonaSpain

AIM To prospectively evaluate the postoperative morbimortality and weight loss evolution of patients who underwent a laparoscopic sleeve gastrectomy(LSG) as a primary bariatric procedure during 5 years of follow-up. METHODS Since 2006,data from patients undergoing a highly restrictive primary LSG have been prospectively registered in a database and analysed. Preoperative co-morbid conditions,operating time,hospital stay,early and late complications rate and evolution of weight loss after 5 years of follow-up were *** A total of 156 patients were included,74.3% of whom were women. The mean age was 43.2 ± 13.1 years and the mean body mass index(BMI) was 41.5 ± 7.9 kg/m^2. Seventy patients(44.8%) presented a BMI under 40 kg/m^2. The mortality rate was 0%. The leakage rate was 1.2%,and the total 30-d morbidity rate was 5.1%(8/156). With a mean follow-up of 32.7 ± 28.5(range 6-112) mo,the mean percent of excess of weight loss(%EWL) was 82.0 ± 18.8 at 1 year,76.7 ± 21.3 at 3 years and 60.3 ± 28.9 at 5 years. The mean percent of excess of BMI loss(%EBMIL) was 94.9 ± 22.4 at 1 year,89.4 ± 27.4 at 3 years and 74.8 ± 29.4 at 5 years. Patients with preoperative BMI less than 40 kg/m^2 achieved greaterweight loss than did the overall study population. Diabetes remitted in 75% of the patients and HTA improved in 71.7%. CPAP masks were withdrawn in all patients with obstructive sleep *** LSG built with a narrow 34 F bougie and starting 3 cm from the pylorus proved to be safe and highly effective in terms of weight loss as a stand-alone procedure,particularly in patients with a preoperative BMI lower than 40 kg/m^2.

关键词： sleeve gastrectomy Morbid obesity Bariatric surgery Obesity surgery Laparoscopy Long-term results 5-year results