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Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery

Roux‐en Y gastric bypass is a highly effective bariatric/metabolic surgical procedure that can induce robust weight loss and even remission of type 2 diabetes. One of the characteristic consequences of Roux‐en Y gastric bypass is the expedited nutrient delivery to the distal small intestine, where L...

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Autores principales: Oh, Tae Jung, Ahn, Chang Ho, Cho, Young Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854512/
https://www.ncbi.nlm.nih.gov/pubmed/27186363
http://dx.doi.org/10.1111/jdi.12444
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author Oh, Tae Jung
Ahn, Chang Ho
Cho, Young Min
author_facet Oh, Tae Jung
Ahn, Chang Ho
Cho, Young Min
author_sort Oh, Tae Jung
collection PubMed
description Roux‐en Y gastric bypass is a highly effective bariatric/metabolic surgical procedure that can induce robust weight loss and even remission of type 2 diabetes. One of the characteristic consequences of Roux‐en Y gastric bypass is the expedited nutrient delivery to the distal small intestine, where L‐cells are abundant and bile acid reabsorption occurs. To examine the role of the distal small intestine in isolation from other components of Roux‐en Y gastric bypass, the ileal transposition (IT) surgery has been used in various rat models. IT relocates the distal ileal segment to the upper jejunum distal to the ligament of Treitz without any other alterations in the gastrointestinal anatomy. Therefore, IT exposes the distal ileal tissue to ingested nutrients after a meal faster than the normal condition. Although there is some inconsistency in the effect of IT according to different types of rat models and different types of surgical protocols, IT typically improved glucose tolerance, increased insulin sensitivity and induced weight loss, and the findings were more prominent in obese diabetic rats. Suggested mechanisms for the metabolic improvements after IT include increased L‐cell secretion (e.g., glucagon‐like peptides and peptide YY), altered bile acid metabolism, altered host–microbial interaction, attenuated metabolic endotoxemia and many others. Based on the effect of IT, we can conclude that the contribution of the distal small intestine to the metabolic benefits of bariatric/metabolic surgery is quite considerable. By unveiling the mechanism of action of IT, we might revolutionize the treatment for obesity and type 2 diabetes.
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spelling pubmed-48545122016-05-16 Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery Oh, Tae Jung Ahn, Chang Ho Cho, Young Min J Diabetes Investig Proceedings of INCRETIN 2015, A Symposium Celebrating the 45th Anniversary of the Discovery of GIP, 29–31 July 2015, Vancouver, Canada. This publication has been supported by: The Local Organizing Committee of INCRETIN 2015 Roux‐en Y gastric bypass is a highly effective bariatric/metabolic surgical procedure that can induce robust weight loss and even remission of type 2 diabetes. One of the characteristic consequences of Roux‐en Y gastric bypass is the expedited nutrient delivery to the distal small intestine, where L‐cells are abundant and bile acid reabsorption occurs. To examine the role of the distal small intestine in isolation from other components of Roux‐en Y gastric bypass, the ileal transposition (IT) surgery has been used in various rat models. IT relocates the distal ileal segment to the upper jejunum distal to the ligament of Treitz without any other alterations in the gastrointestinal anatomy. Therefore, IT exposes the distal ileal tissue to ingested nutrients after a meal faster than the normal condition. Although there is some inconsistency in the effect of IT according to different types of rat models and different types of surgical protocols, IT typically improved glucose tolerance, increased insulin sensitivity and induced weight loss, and the findings were more prominent in obese diabetic rats. Suggested mechanisms for the metabolic improvements after IT include increased L‐cell secretion (e.g., glucagon‐like peptides and peptide YY), altered bile acid metabolism, altered host–microbial interaction, attenuated metabolic endotoxemia and many others. Based on the effect of IT, we can conclude that the contribution of the distal small intestine to the metabolic benefits of bariatric/metabolic surgery is quite considerable. By unveiling the mechanism of action of IT, we might revolutionize the treatment for obesity and type 2 diabetes. John Wiley and Sons Inc. 2016-03-14 2016-04 /pmc/articles/PMC4854512/ /pubmed/27186363 http://dx.doi.org/10.1111/jdi.12444 Text en © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Proceedings of INCRETIN 2015, A Symposium Celebrating the 45th Anniversary of the Discovery of GIP, 29–31 July 2015, Vancouver, Canada. This publication has been supported by: The Local Organizing Committee of INCRETIN 2015
Oh, Tae Jung
Ahn, Chang Ho
Cho, Young Min
Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery
title Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery
title_full Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery
title_fullStr Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery
title_full_unstemmed Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery
title_short Contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: Lessons from ileal transposition surgery
title_sort contribution of the distal small intestine to metabolic improvement after bariatric/metabolic surgery: lessons from ileal transposition surgery
topic Proceedings of INCRETIN 2015, A Symposium Celebrating the 45th Anniversary of the Discovery of GIP, 29–31 July 2015, Vancouver, Canada. This publication has been supported by: The Local Organizing Committee of INCRETIN 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854512/
https://www.ncbi.nlm.nih.gov/pubmed/27186363
http://dx.doi.org/10.1111/jdi.12444
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