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ID: 783 (Conflict of Interest: K)

Die positive Auswirkung der Sleeve-Gastrektomie auf Metabolismus und Leberfunktion ist abhängig von einer postoperativen Ernährungsumstellung im Adipositas-induzierten Tiermodell

J.Dohmen, F. E.Uschner, S.Klein, A.Rudeloff, R.Schierwagen, S.Wehner, H.Matthaei, J. C.Kalff, J.Trebicka, P.Lingohr
Universitätsklinikum Bonn, Bonn

Einleitung

Sleeve gastrectomy (SG) is an effective procedure to treat morbid obesity. SG induces remission of type 2 diabetes and metabolic syndrome and improves non-alcoholic fatty liver disease (NAFLD). However, to what extent these beneficial effects are attributed to the SG or the concomitant change in postoperative diet remains unanswered. This study addresses this question in a rodent model of obesity receiving either SG, change to normal diet or their combination.

Material und Methoden

Male Wistar-rats were fed high fat diet (HFD, n=32) or received normal chow (n=8). After 15 weeks HFD-fed rats received either SG or sham operation, and after surgery these groups were randomized to either continuing HFD or switched to normal diet for another 9 weeks until all animals were sacrificed. Body weight, fasting blood glucose level and leptin expression in adipose tissue were assessed at surgery and at sacrifice. Portal pressure was measured in vivo at sacrifice, while liver fibrosis and inflammation was assessed using histological evaluation and RT-PCR of suitable markers.

Ergebnisse

SG, independent of the diet, as well as postoperative diet change, independent on the operation, both caused a significant weight loss, blood sugar reduction and leptin expression. Importantly, the combination of SG with post-operative normal diet achieved the greatest beneficial effects compared to post-operative diet change and SG alone. αSMA mRNA expression, Sirius red staining and hepatic hydroxyprolin-content are significantly reduced only after the combination of SG with a postoperative normal diet, while Col1A1 is reduced after SG regardless of post-operative diet. Surprisingly, portal pressure remained unchanged after SG with postoperative normal diet, but increased after SG and continued postoperative HFD. Hepatic MCP-1 and TNFα mRNA levels were reduced either by SG or by switch to normal diet alone, while this effect was more pronounced by their combination. 

Schlussfolgerung

HFD for 15 weeks induced obesity with metabolic syndrome and NAFLD in rats. Both sleeve-gastrectomy and switch to normal diet after surgery could improve metabolic state and NAFLD, but their combination showed the greatest beneficial effects.