Objective: The aim of this study was to explore the protective effects and the regulatory mechanisms of bariatric surgery on kidney injury in diabetic rats.
Methods: We established a useful type 2 diabetic rat model using high-fat and high-sugar diet feeding following low-dose streptozotocin (STZ) treatment. Sprague-Dawley (SD) rats were randomly divided into the following groups: control (Con) group, diabetic nephropathy (DN) group, and duodenal-jejunal bypass (DJB) surgery group. The food intake and body weight of rats were monitored and the glucose tolerance test (OGTT) test was performed every 2 weeks. The glomerular filtration rate (GFR) and urinary albumin excretion rate (UAFR) were measured to assess renal function. Hematoxylin-eosin (H&E), periodic acid-Schiff (PAS), and Masson staining were used to evaluate renal histopathological changes. TUNEL assay was performed to detect cell apoptosis. The expressions of oxidative stress factors and inflammatory factors in the renal tissues of rats were detected by ELISA. The expressions of PPARα, reactive oxygen species (ROS), and NF-κB were detected by immunofluorescence. For experiment, HK2 cells cultured with high glucose were treated with PPARα agonist, PPARα antagonist, and adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) agonist. The expressions of AMPK/PPARα/NF-κB signaling pathway-related proteins were detected by Western blot.
Results: Bariatric surgery improved the glucose tolerance of DN rats. The GFR was decreased, the promotion of urinary albumin excretion rate (UAER) was inhibited, and the renal injury was alleviated. The extracellular matrix fraction was decreased and the renal function was improved. Meanwhile, bariatric surgery activates PPARα, inhibits ROS release, reduces oxidative stress injury, and reduces renal cell apoptosis. experiment results showed that the AMPK activator could activate PPARα, downregulate NF-κB, and inhibit inflammatory response. The phosphorylation of AMPK was inhibited by PPARα antagonism.
Conclusion: Bariatric surgery can activate PPARα, inhibit oxidative stress injury, and improve glucose metabolism and renal function in DN rats.
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http://dx.doi.org/10.3389/fphys.2021.662666 | DOI Listing |
Arq Gastroenterol
December 2024
Instituto de Cardiologia, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brasil.
Background: Several preoperative pulmonary assessment protocols have been established over the years, but assessments of this magnitude are lacking in the bariatric population. Therefore, the assessment of lung capacity, maximum inspiratory and expiratory pressures, the peak expiratory flow and mobility can be predictors of operative safety and determine the time of hospital discharge.
Objective: To evaluate lung capacity, respiratory muscle strength and level of mobility in the pre, immediate post-operative and hospital discharge of patients undergoing bariatric surgery.
Obes Surg
January 2025
Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
Background: Obesity is one of the most important health problems in the world. It affects all systems, especially the respiratory and cardiovascular systems. Laparoscopic sleeve gastrectomy is an effective method in the treatment of obesity and can improve respiratory functions.
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January 2025
Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland.
Background: Anastomotic ulcers (AU) at the gastroenterostomy are a common postoperative complication after laparoscopic Roux-en-Y gastric bypass (LRYGB). Possible risk factors for ulcer formation include active smoking, the use of non-steroidal anti-inflammatory drugs, increased tension or ischemia at the anastomosis, or factors that increase the acid secretion of the gastric pouch. Therefore, a longer gastric pouch may increase risk of AU formation after LRYGB.
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January 2025
Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Background: Previous studies showed a high conversion rate and failure of restrictive procedures, including sleeve gastrectomy (SG), adjustable gastric banding (AGB), gastric plication (GP), and vertical banded gastroplasty (VBG) in a long-term follow-up. The current study aims to evaluate the efficacy and safety of a revisional one anastomosis gastric bypass (OAGB) for weight loss and treatment of obesity-related problems after primary metabolic and bariatric restrictive procedures.
Methods: A retrospective study on prospectively collected data was conducted on a sample of 151 patients who experienced insufficient weight loss or weight regain after primary restrictive surgeries and underwent OAGB as a revisional procedure.
Background: Obesity is a significant risk factor for chronic kidney disease (CKD), with metabolic bariatric surgery offering potential renal benefits. However, there is limited comparative data on the impact of Roux-en-Y gastric bypass (RYGB) versus laparoscopic sleeve gastrectomy (LSG) on renal function in individuals with obesity without end-stage renal disease (ESRD). The objective of this study was to compare renal function outcomes following RYGB and LSG in patients with obesity, focusing on estimated glomerular filtration rate (eGFR), serum creatinine, albumin-creatinine ratio (ACR), and serum cystatin C.
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