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This Article Full Text Full Text (PDF) Supplemental Methods All Versions of this Article: 297/5/G950    most recent 00253.2009v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Stearns, A. T. Articles by Tavakkolizadeh, A. PubMed PubMed Citation Articles by Stearns, A. T. Articles by Tavakkolizadeh, A.

MUCOSAL BIOLOGY

Impact of Roux-en-Y gastric bypass surgery on rat intestinal glucose transport

¹Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts; ²Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom; and ³School of Clinical Sciences, Division of Gastroenterology, University of Liverpool, Liverpool, United Kingdom

Submitted June 29, 2009 ; accepted in final form September 2, 2009

Roux-en-Y gastric bypass (RYGB) has become the gold-standard bariatric procedure, partly because of the rapid resolution of accompanying diabetes. There is increasing evidence this is mediated by duodenal exclusion. We hypothesize that duodenal exclusion suppresses intestinal Na⁺/glucose cotransporter SGLT1-mediated glucose transport, improving glucose handling, and aimed to test this in a rodent RYGB model. Sprague-Dawley rats underwent sham procedure or duodenal exclusion by RYGB (10 cm Roux, 16 cm biliopancreatic limbs). Animals were maintained for 3 wk on a Western diet, before harvest at 10 AM, 4 PM, and 10 PM. Sections were taken from each limb for hematoxylin and eosin staining, and morphological assessment was performed. Functional glucose uptake studies, along with Western blotting and quantitative PCR, were performed on Roux limb. Histology showed morphometric changes in Roux and common limbs, with increase in villus height and crypt depth compared with BP and sham jejunum. Despite this, glucose transport was reduced by up to 68% (P < 0.001) in the Roux limb compared with sham jejunum. Normal diurnal rhythms in glucose uptake were ablated. This occurred at a posttranscriptional level, with little change in message but appearance of different weight species of Sglt1 on Western blotting. We have shown duodenal exclusion significantly influences both intestinal structure and glucose transport function, with glucose absorptive capacity reduced after RYGB. This provides a novel mechanistic explanation for some of the antidiabetic effects of RYGB.

bariatric surgery; diabetes; sglt1