Metabolic comparison of one-anastomosis gastric bypass, single-anastomosis duodenal-switch, Roux-en-Y gastric bypass, and vertical sleeve gastrectomy in rat

Oct 8, 2018Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Metabolic differences between four types of weight-loss surgery in rats

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Abstract

All bariatric procedures induced weight loss compared with sham that lasted throughout the 15-week study period.

The highest percent fat loss was observed after one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB).
Improved glucose dynamics were noted across all surgical procedures, with OAGB and single-anastomosis duodenal switch (SADS) showing increased insulin secretion.
Circulating cholesterol levels decreased in patients undergoing OAGB, vertical sleeve gastrectomy (SG), and RYGB.
OAGB and SG also led to reductions in circulating triglycerides.
Liver triglycerides were reduced most significantly after OAGB and RYGB.
All surgical groups experienced decreased circulating iron levels, associated with lower hematocrit and increased reticulocyte counts.

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BACKGROUND: One-anastomosis gastric bypass (OAGB) and single-anastomosis duodenal switch (SADS) have become increasingly popular weight loss strategies. However, data directly comparing the effectiveness of these procedures with Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (SG) are limited.

OBJECTIVES: To examine the metabolic outcomes of OAGB, SADS, RYGB, and SG in a controlled rodent model.

SETTING: Academic research laboratory, United States.

METHODS: Surgeries were performed in diet-induced obese Long-Evans rats, and metabolic outcomes were monitored before and for 15 weeks after surgery.

RESULTS: All bariatric procedures induced weight loss compared with sham that lasted throughout the course of the study. The highest percent fat loss occurred after OAGB and RYGB. All bariatric procedures had improved glucose dynamics associated with an increase in insulin (notably OAGB and SADS) and/or glucagon-like protein-1 secretion. Circulating cholesterol was reduced in OAGB, SG, and RYGB. OAGB and SG additionally decreased circulating triglycerides. Liver triglycerides were most profoundly reduced after OAGB and RYGB. Circulating iron levels were decreased in all surgical groups, associated with a decreased hematocrit value and increased reticulocyte count. The fecal microbiome communities of OAGB, SADS, and RYGB were significantly altered; however, SG exhibited no change in microbiome diversity or composition.

CONCLUSIONS: These data support the use of the rat for modeling bariatric surgical procedures and highlight the ability of the OAGB to meet or exceed the metabolic improvements of RYGB. These data point to the likelihood that each surgery accomplishes metabolic improvements through both overlapping and distinct mechanisms and warrants further research.

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Metabolic comparison of one-anastomosis gastric bypass, single-anastomosis duodenal-switch, Roux-en-Y gastric bypass, and vertical sleeve gastrectomy in rat

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