Characterization of one anastomosis gastric bypass and impact of biliary and common limbs on bile acid and postprandial glucose metabolism in a minipig model

Background/Objectives: The alimentary limb has been proposed to be a key driver of the weight-loss-independent metabolic improvements that occur upon bariatric surgery. However, the One Anastomosis Gastric Bypass (OAGB) procedure, consisting of one long biliary limb and a short common limb, induces stronger beneficial metabolic effects compared to Roux-en-Y Gastric Bypass (RYGB) in humans, despite the lack of an alimentary limb. The aim of this study was to assess the role of the biliary and common limbs in the weight-loss and metabolic effects that occur upon OAGB. Subjects/Methods: OAGB and sham surgery, with or without modifications of the length of either the biliary limb or the common limb, were performed in Gottingen-like minipigs. Weight loss, metabolic changes, and the effects on plasma and intestinal bile acids (BAs) were assessed 15 days after surgery. Results: OAGB significantly decreased body weight, improved glucose homeostasis, increased postprandial GLP-1 and fasting plasma BAs, and qualitatively changed the intestinal BA species composition. Resection of the biliary limb prevented the body weight loss effects of OAGB and attenuated the postprandial GLP-1 increase. Improvements in glucose homeostasis along with changes in plasma and intestinal BAs occurred after OAGB regardless of the biliary limb length. Resection of only the common limb reproduced the glucose homeostasis effects and the changes in intestinal BAs. Conclusions: Our results suggest that the changes in glucose metabolism and BAs after OAGB are mainly mediated by the length of the common limb, whereas the length of the biliary limb contributes to body weight loss.

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Gastric Bypass Surgery Causes Body Weight Loss Without Reducing Food Intake in Rats

Obesity Surgery ◽

10.1007/s11695-007-9392-8 ◽

2008 ◽

Vol 18 (4) ◽

pp. 415-422 ◽

Cited By ~ 25

Author(s):

Marianne W. Furnes ◽

Karin Tømmerås ◽

Carl-Jørgen Arum ◽

Chun-Mei Zhao ◽

Duan Chen

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Food Intake ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Body Weight Loss

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Vagal Sparing Surgical Technique but Not Stoma Size Affects Body Weight Loss in Rodent Model of Gastric Bypass

Obesity Surgery ◽

10.1007/s11695-010-0075-5 ◽

2010 ◽

Vol 20 (5) ◽

pp. 616-622 ◽

Cited By ~ 61

Author(s):

Marco Bueter ◽

Christian Löwenstein ◽

Hutan Ashrafian ◽

Jacquelien Hillebrand ◽

Stephen R. Bloom ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Surgical Technique ◽

Body Weight Loss ◽

Rodent Model

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EARLY WEIGHT LOSS OUTCOMES AND GLUCOSE METABOLISM PARAMETERS AFTER BANDED VERSUS NON-BANDED ONE ANASTOMOSIS GASTRIC BYPASS: A PROSPECTIVE RANDOMIZED TRIAL

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-14 ◽

2019 ◽

Vol 56 (1) ◽

pp. 15-21 ◽

Cited By ~ 2

Author(s):

Everton CAZZO ◽

Felipe Gilberto VALERINI ◽

Fábio Henrique Mendonça CHAIM ◽

Pedro França da Costa SOARES ◽

Almino Cardoso RAMOS ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Glucose Metabolism ◽

Randomized Study ◽

Standard Technique ◽

One Anastomosis Gastric Bypass ◽

Morbidly Obese ◽

Model Assessment ◽

Post Surgery ◽

Early Weight Loss

ABSTRACT BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.

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QS83. Muscle Loss Constitutes A Significant Component of Body Weight Loss in Morbidly Obese Patients Following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB)

Journal of Surgical Research ◽

10.1016/j.jss.2007.12.323 ◽

2008 ◽

Vol 144 (2) ◽

pp. 301-302

Author(s):

Aaron W. Eckhauser ◽

Homaira Ayesha Hossain ◽

Pamela A. Marks ◽

James M. Isbell ◽

Philip E. Williams ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Body Weight ◽

Body Weight Loss ◽

Morbidly Obese ◽

Obese Patients ◽

Muscle Loss ◽

Significant Component

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Amylin-Mediated Restoration of Leptin Responsiveness in Diet-Induced Obesity: Magnitude and Mechanisms

Endocrinology ◽

10.1210/en.2008-0770 ◽

2008 ◽

Vol 149 (11) ◽

pp. 5679-5687 ◽

Cited By ~ 102

Author(s):

James L. Trevaskis ◽

Todd Coffey ◽

Rebecca Cole ◽

Chunli Lei ◽

Carrie Wittmer ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Food Intake ◽

Combination Treatment ◽

Body Weight Loss ◽

Metabolic Effects ◽

Fat Utilization ◽

Diet Induced Obesity ◽

Expression Of Genes ◽

Obese Rats

Previously, we reported that combination treatment with rat amylin (100 μg/kg·d) and murine leptin (500 μg/kg·d) elicited greater inhibition of food intake and greater body weight loss in diet-induced obese rats than predicted by the sum of the monotherapy conditions, a finding consistent with amylin-induced restoration of leptin responsiveness. In the present study, a 3 × 4 factorial design was used to formally test for a synergistic interaction, using lower dose ranges of amylin (0, 10, and 50 μg/kg·d) and leptin (0, 5, 25, and 125 μg/kg·d), on food intake and body weight after 4 wk continuous infusion. Response surface methodology analysis revealed significant synergistic anorexigenic (P < 0.05) and body weight-lowering (P < 0.05) effects of amylin/leptin combination treatment, with up to 15% weight loss at doses considerably lower than previously reported. Pair-feeding (PF) experiments demonstrated that reduction of food intake was the predominant mechanism for amylin/leptin-mediated weight loss. However, fat loss was 2-fold greater in amylin/leptin-treated rats than PF controls. Furthermore, amylin/leptin-mediated weight loss was not accompanied by the counterregulatory decrease in energy expenditure and chronic shift toward carbohydrate (rather than fat) utilization observed with PF. Hepatic gene expression analyses revealed that 28 d treatment with amylin/leptin (but not PF) was associated with reduced expression of genes involved in hepatic lipogenesis (Scd1 and Fasn mRNA) and increased expression of genes involved in lipid utilization (Pck1 mRNA). We conclude that amylin/leptin interact synergistically to reduce body weight and adiposity in diet-induced obese rodents through a number of anorexigenic and metabolic effects.

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