In recent years bariatric operations are more often used for treatment of patients with obesity complicated with metabolic syndrome and type 2 diabetes mellitus (DM). Bariatric operations leads to incretin level increasing. It is known that incretins stimulates β-cell proliferation, induction of islet neogenesis and inhibition of β-cell apoptosis, thus promoting expansion of β-cell mass. One of the promising bariatric operations is gastric plication.

Aim: To study influence of gastric plication on course of diabetes mellitus in rats. Methods: We used 42 male white rats, mean weight 154 g. All animals were randomly divided into 4 groups: I (n = 8) – control group; II (n = 8) – rats with performed gastric plication (GP) operation without DM; III (n = 8) – rats with streptozotocin (STZ) inducted DM; IV (n = 18) – rats with DM and performed gastric plication. The DM in rats was inducted by four time intraperitoneal injection of STZ (40 mg/kg body weight). Diabetes was inducted in III and IV group at the beginning of experiment. Gastric plication was performed in II and IV group three months after the experiment began. Diabetes mellitus is considered to exist together with blood glucose level higher than 14 mmol/l. At the end of the experiment blood was taken from heart chambers for biochemical tests. Stomach, pancreas, duodenal, part of the ileum, ascending colon, heart, liver, kidney, adrenal gland and spleen were taken for histological examination.

Results: We examined the animals from the first group as control. At the end of experiment weight of animals from III and IV groups was 12 and 16 % lower compared with the control group. Weight of rats from II group was only 6,9 % lower compared with the control group. Water consumption was 24 % and 5,3 % higher in animals of III and IV group compared with I group at the end of the experiment. The difference between I and II groups was only 1,3%. Four months from the beginning of the experiment (1 month after GP) mean blood glucose level in III group was 28,1 ± 0,51 and 23,4 ± 0,74 mmol/l in IV group respectively. After 5 months (2 months after GP) 25,9 ± 0,6 and 17,5 ± 1,6 mmol/l in III and IV groups, respectively. At the end of the experiment the mean blood glucose level in III group was 25 ± 0,1 mmol/l and 12,3 ± 2,37 mmol/l in IV group. Among animals of IV group, at the end of the experiment, the following results were observed:

– Normoglycemia (blood glucose < 6,0 mmol/l) in 6 (54,55 %); – Partial reduction of blood glucose level in 3 (27,27 %) animals; – No effect (glucose as in the third group) in 2 (18,18 %) animals. Mean blood glucose level I and II groups was 5,34 ± 0,069.

Mean AST level in animals of I and II group was 34,11 ± 0,3 and 33,4 ± 0,27 IU/L. InIII and IV group 200,87 ± 1,05 and 200,54 ± 1,52 IU/L.

Mean ALT level in animals of I and II groups was 34,9 ± 0,52 and 35,4 ± 0,49 IU/L. In III and IV group 127,25 ± 3,31 ± 7,86 and 111 IU/L.

Mean amylase level in animals of I and II groups was 77,7 ± 0,6 and 76,4 ± 0,98 IU/L. In III and IV group 1470 and 1452 ± 20,8 ± 34,3 IU/L.

Conclusions:
Gastric plication is absolutely safe operation because comparable indicators in I and II groups were practically identical.

Postoperative blood glucose level was significantly lower in III group compared with IV group.

Gastric plication has a positive influence on course of experimental diabetes mellitus in rats and needs further research.

Ключові слова: gastric plication, bariatric surgery, diabetes mellitus, rat, streptozotocin

Повний текст: PDF (Ukr)

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