Duodenal-Jejunal Bypass Improves Insulin Resistance by Enhanced Glucagon-Like Peptide-1 Secretion Through Increase of Bile Acids

作者：Kashihara Hideya; Shimada Mitsuo^*; Kurita Nobuhiro; Iwata Takashi; Sato Hirohiko; Yoshikawa Kozo; Miyatani Tomohiko; Takasu Chie; Matsumoto Noriko; Ishibashi Hiroki

来源：Hepato-Gastroenterology, 2014, 61(132): 1049-1054.

DOI：10.5754/hge13029

• Duodenal-jejunal bypass
• insulin resistance
• bile acids
• Glucagon-like peptide-1 (GLP-1)
• L cells
• Sprague-Dawley rat

Background/Aims: The aim of this study is to investigate the mechanisms of improvement in insulin resistance after duodenal-jejunal bypass (DJB), especially regarding the correlation between bile acids and glucagon-like peptide-1 (GLP-1). Methodology: SD rats were divided into two groups: DJB or Sham group. Blood glucose, insulin, GLP-1, bile acids, and the number of L cells in the small intestine were investigated three weeks after the operations. Next, to assess the effect of the bile acids on GLP-1 secretion in ileum, bile diversion model (=inhibition of rapid bile exposure to the ileum; BD group) were performed and postoperative glycemic parameters were measured. Results: DJB improved insulin resistance and increased GLP-1 compared with sham. Higher bile acids in DJB were found than that in sham. The number of L cells in the common limb of DJB was increased compared with that in the distal segment of sham. In BD group, insulin resistance had not improved. GLP-1, bile acids, and the number of L cells revealed no significant changes compared with sham. Conclusions: DJB has a potential to improve insulin resistance, which may be related to enhanced GLP-1 secretion through the increase of bile acids in the common limb of the small intestine.

• 出版日期2014-6