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Analysis of the Efficacy and the Long-term Metabolic and Nutritional Status of Sleeve Gastrectomy with Transit Bipartition Compared to Roux-en-Y Gastric Bypass in Obese Rats

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Abstract

Purpose

Sleeve gastrectomy with transit bipartition (SG-TB) could be an attractive alternative to Roux-en-Y gastric bypass (RYGB) on weight loss and improvement of comorbidities in patients with obesity. However, there is little long-term data. Translational research on a rat model could allow long-term projection to assess efficacy and safety of SG-TB. The aim of this research was to evaluate the long-term efficacy and safety of SG-TB compared to RYGB and SHAM in rat model.

Materials and Methods

Ninety-four male obese Wistar rats were distributed into 3 groups: SG-TB (n = 34), RYGB (n = 32), and SHAM (control group, n = 28). The percentage of total weight loss (%TWL), coprocalorimetry, glucose and insulin tolerance test, insulin, GLP-1, PYY, and GIP before and after surgery were assessed. The animals were followed over 6 months (equivalent to 16 years in humans).

Results

At 6 months, %TWL was significantly greater(p = 0.025) in the SG-TB group compared to the RYGB group. There was no difference between the groups (p = 0.86) in malabsorption 15 and 120 days postoperatively. Glucose tolerance was significantly improved (p = 0.03) in the SG-TB and RYGB groups compared to the preoperative state. Insulin secretion, at 3 months, was significantly more important in the SG-TB group (p = 0.0003), compared to the RYGB and SHAM groups. GLP-1 secretion was significantly increased in the SG-TB and RYGB groups compared to the preoperative state (p = 0.001) but similar between SG-TB and RYGB animals (p = 0.72).

Conclusion

In a rat model, at long term compared to RYGB, SG-TB provides greater and better-maintained weight loss and an increased insulin secretion without impairing nutritional status.

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Acknowledgements

We thank the group of Prof. N. Kapel of the Department of Functional Coprology, APHP, and especially Dr. L. Barbot-Trystram for stool analyses. We thank N. Sorhaindo, Biochemistry Platform CRI, for plasma samples analyses and Dr. G. Rucher from the Fédération de Recherche en Imagerie Multimodalités (FRIM) for Tomodensitometry analyses.

Funding

Société Française et Francophone de Chirurgie de l’Obésité et des Maladies Métaboliques (SOFFCO-MM), Société francophone de nutrition clinique et métabolisme (SFNCM), AP-HP

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Authors and Affiliations

  1. Université de Paris Cité, F-75015, Paris, France

    Clement Baratte, Alexandra Willemetz, Lara Ribeiro-Parenti, Claire Carette, Simon Msika, Andre Bado, Sebastien Czernichow, Maude Le Gall & Tigran Poghosyan

  2. INSERM, U1149, Centre de Recherche sur l’Inflammation, 75018, Paris, France

    Clement Baratte, Alexandra Willemetz, Lara Ribeiro-Parenti, Simon Msika, Andre Bado, Maude Le Gall & Tigran Poghosyan

  3. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de chirurgie digestive, œsogastrique et bariatrique, Centre Spécialisé Obésité (CSO) Ile de France Nord, Hôpital Bichat-Claude Bernard, 16 rue Henri Huchard, 75018, Paris, France

    Clement Baratte, Lara Ribeiro-Parenti, Simon Msika & Tigran Poghosyan

  4. Assistance Publique-Hôpitaux de Paris, service de Nutrition, Centre Spécialisé Obésité (CSO) Ile de France Sud, Hôpital Européen Georges Pompidou, 75015, Paris, France

    Claire Carette & Sebastien Czernichow

  5. Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004, Paris, France

    Sebastien Czernichow

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  1. Clement Baratte
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Corresponding author

Correspondence to Tigran Poghosyan.

Ethics declarations

Ethics Approval

All animal studies comply with the ARRIVE guidelines. They were conducted in accordance with EU directive 2010/63/EU for animal experiments and approved by the Institutional Animal Care and Use Committee (CEA N° 121) and the French Ministry of Higher Education.

Informed Consent

Informed consent does not apply.

Conflict of Interest

Claire Carette reported personal fees from Ipsen Pharma, Pfizer, AstraZeneca, Novo Nordisk, Lilly, Vitalaire, and Merck France outside the submitted work. Sebastien Czernichow reported participation fees from Mygoodlife; personal fees from Novonordisk, Fresenius, Lilly, Janssen, and Bristol Myers Squibb; and other fees from Jellynov outside the submitted work. Tigran Poghosyan reported receiving personal fees from BariaTek, Novo Nordisk, and Gore outside the submitted work. No other disclosures were reported.

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Key Points

-In rat, compared to RYGB, SG-TB provides greater and better maintained weight loss.

-Insulin secretion is enhanced in the SG-TB rat model, compared to RYGB.

-In the long term, SG-TB appears to be a sustainable alternative to RYGB.

Maude Le Gall and Tigran Poghosyan are co-last authors.

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Baratte, C., Willemetz, A., Ribeiro-Parenti, L. et al. Analysis of the Efficacy and the Long-term Metabolic and Nutritional Status of Sleeve Gastrectomy with Transit Bipartition Compared to Roux-en-Y Gastric Bypass in Obese Rats. OBES SURG 33, 1121–1132 (2023). https://doi.org/10.1007/s11695-023-06477-7

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