Ileum excision partially reverses improvement of glucose metabolism in diabetic rats after biliopancreatic diversion with duodenal switch.

Bile acids can stimulate the secretion of glucagon-like peptide-1 (GLP-1) and be mostly reabsorbed in the ileum. We aimed to investigate whether ileum excision could reverse the glucose improvement after biliopancreatic diversion with duodenal switch (BPD/DS). Peking Union Medical College Hospital. Thirty diabetic rats were randomly divided into the BPD/DS group, BPD/DS plus ileectomy (BDI) group, and control group. The fasting blood glucose, bile acids, and glucagon-like peptide-1(GLP-1) levels in plasma samples were analyzed. In postoperative week 20, the fasting blood glucose level in the BDI group was significantly higher than that in the BPD/DS group (11.5 ± 1.4 mmol/L versus 7.6 ± 1.0 mmol/L, P <.001), and the AUC OGTT value was also significantly higher than that in the BPD/DS group (2186.1 ± 237.2 mmol/L·min versus 1551.2 ± 136.9 mmol/L·min, P <.001). The plasma level of bile acids in the BDI group was lower than that in the BPD/DS group (P =.012) and was not significantly different from that in the control group (P =.629). The plasma level of GLP-1 in the BDI group was lower than that in the BPD/DS group (P =.009) and was not significantly different from that in the control group (P =.530). Moreover, the intestinal TGR5 expression in the BDI group was significantly lower than that in the BPD/DS group (P <.001). The results show that excision of the ileum can partially reverse the improvement in glucose metabolism after BPD/DS. • Excision of the ileum can reverse the improvement in glucose metabolism after biliopancreatic diversion with duodenal switch (BPD/DS). • The plasma level of bile acids decreased in rats with ileal excision. • The plasma level of glucagon-like peptide-1 decreased in rats with ileal excision. • Ileum should be carefully protected when bariatric surgeries involved gastrointestinal reconstruction. [ABSTRACT FROM AUTHOR]