The Effects of Antral Preservation and Antral Resection on Body Composition, Glycemic Control and Bone Mineral Density Following Vertical Sleeve Gastrectomy in C57BL/6J Mice with Obesity and Type 2 Diabetes

Abstract

Purpose

Sleeve gastrectomy (SG) is the most currently popular operation for obesity and related metabolic disorders. The aim of this study was to compare the effect of antrum preservation SG (AP-SG) and antrum resection SG (AR-SG) on the body composition, glycemic control and bone mineral density (BMD) in mice.

Methods

Sham, AP-SG and AR-SG operation were performed on obese and T2D C57BL/6J mice (8 in each group). Body weight, food intake, and fasting glucose (FG) levels were measured at the 0, 2, 4, 6 and 8 weeks post-operatively. Oral glucose tolerance test (OGTT) was performed preoperatively and at the eighth postoperative week. The body fat content and total body BMD were evaluated by dual-energy x-ray absorptiometry. After being euthanized, the femurs were harvested and analyzed by micro-CT.

Results

The improvements in body weight, food intake, FG, glycemic control and body fat were statistically significant following AP-SG and AR-SG. Both AP-SG and AR-SG groups decreased total body BMD and regional BMD in the distal femur compared to the sham group. No significant difference of FG was observed in AP-SG and AR-SG group postoperatively, but AR-SG showed significantly superior OGTT glucose AUC than AP-SG. Except for a lower BMD, AR-SG achieved superior outcomes in body fat and glycemic control than AP-SG.

Conclusion

Antrum resection SG shows a lower percentage of body fat and better glycemic control than antrum preservation SG. However, antrum resection SG has a higher risk of having a lower bone mass. Further human clinical trials are needed to confirm this finding.

Keywords:

• sleeve gastrectomy
• antrum preservation
• antrum resection
• body fat
• bone mineral density

Abbreviations

SG, sleeve gastrectomy; AP-SG, antrum preservation sleeve gastrectomy; AR-SG, antrum resection sleeve gastrectomy; BMD, bone mineral density; FG, fasting glucose; OGTT, oral glucose tolerance test; HFD, high fat diet; DEXA, dual-energy X-ray absorptiometry; WAT, white adipose tissue; PFA, paraformaldehyde; H&E, hematoxylin and eosin; BV, bone volume; BV/TV, bone volume per tissue volume.

Ethics Approval

All experiments with mice were authorized and performed in accordance with the Animal Care and Use Committee (permission number: 2021AE01033). All animal care and use protocols were approved by the Committee on the Ethics of Animal Experiments.

Consent for Publication

No conflict of interest exists in the submission of this manuscript, and all authors have approved the manuscript for submission.

Acknowledgments

We would like to thank Jiawei Li, Zhongyang Lv, Zhenhua Feng and Zhuang Qian for their kind advice of experimental skills.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by the Natural Science Foundation of Jiangsu Province (Grant No. BK20181155) and the 333 Project of Jiangsu Province (Grant No. BRA2017109).