Karl J Neff1, Jessie A Elliott2, Caroline Corteville3, Kathrin Abegg4, Camilo Boza5, Thomas A Lutz4, Neil G Docherty6, Carel W le Roux7. 1. Diabetes Complications Research Centre, Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland. 2. Diabetes Complications Research Centre, Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland; Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland. 3. Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland; Department of Surgery, University of Wurzburg, Wurzburg, Germany. 4. Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland. 5. Bariatric Surgery, Clinica Las Condes, Santiago, Chile. 6. Diabetes Complications Research Centre, Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland. Electronic address: neil.docherty@ucd.ie. 7. Diabetes Complications Research Centre, Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland; Gastrosurgical Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Abstract
BACKGROUND: Reductions in urinary protein excretion after Roux-en-Y gastric bypass (RYGB) surgery in patients with diabetic kidney disease have been reported in multiple studies. OBJECTIVES: To determine the weight loss dependence of the effect of RYGB on urinary protein excretion by comparing renal outcomes in Zucker diabetic fatty rats undergoing either gastric bypass surgery or a sham operation with or without weight matching. SETTING: University laboratories. METHODS: Zucker diabetic fatty rats underwent surgery at 18 weeks of age. A subgroup of sham operated rats were weight matched to RYGB operated rats by restricting food intake. Urinary protein excretion was assessed at baseline and at postoperative weeks 4 and 12. Renal histology and macrophage-associated inflammation were assessed at postoperative week 12. RESULTS: Progressive urinary protein excretion was attenuated by both RYGB and diet-induced weight loss, albeit to a lesser extent by the latter. Both weight loss interventions produced equivalent reductions in glomerulomegaly, glomerulosclerosis, and evidence of renal macrophage infiltration. CONCLUSION: Weight loss per se improves renal structure and attenuates renal inflammatory responses in an experimental animal model of diabetic kidney disease. Better glycemic control post-RYGB may in part explain the greater reductions in urinary protein excretion after gastric bypass surgery.
BACKGROUND: Reductions in urinary protein excretion after Roux-en-Y gastric bypass (RYGB) surgery in patients with diabetic kidney disease have been reported in multiple studies. OBJECTIVES: To determine the weight loss dependence of the effect of RYGB on urinary protein excretion by comparing renal outcomes in Zucker diabetic fattyrats undergoing either gastric bypass surgery or a sham operation with or without weight matching. SETTING: University laboratories. METHODS: Zucker diabetic fattyrats underwent surgery at 18 weeks of age. A subgroup of sham operated rats were weight matched to RYGB operated rats by restricting food intake. Urinary protein excretion was assessed at baseline and at postoperative weeks 4 and 12. Renal histology and macrophage-associated inflammation were assessed at postoperative week 12. RESULTS: Progressive urinary protein excretion was attenuated by both RYGB and diet-induced weight loss, albeit to a lesser extent by the latter. Both weight loss interventions produced equivalent reductions in glomerulomegaly, glomerulosclerosis, and evidence of renal macrophage infiltration. CONCLUSION:Weight loss per se improves renal structure and attenuates renal inflammatory responses in an experimental animal model of diabetic kidney disease. Better glycemic control post-RYGB may in part explain the greater reductions in urinary protein excretion after gastric bypass surgery.
Authors: William P Martin; Daniel Malmodin; Anders Pedersen; Martina Wallace; Lars Fändriks; Cristina M Aboud; Tarissa B Zanata Petry; Lívia P Cunha da Silveira; Ana C Calmon da Costa Silva; Ricardo V Cohen; Carel W le Roux; Neil G Docherty Journal: Metabolites Date: 2022-02-02
Authors: Allon N Friedman; Abdus S Wahed; Junyao Wang; Anita P Courcoulas; Gregory Dakin; Marcelo W Hinojosa; Paul L Kimmel; James E Mitchell; Alfons Pomp; Walter J Pories; Jonathan Q Purnell; Carel le Roux; Konstantinos Spaniolas; Kristine J Steffen; Richard Thirlby; Bruce Wolfe Journal: J Am Soc Nephrol Date: 2018-01-15 Impact factor: 10.121
Authors: Meera Nair; William P Martin; Vadim Zhernovkov; Jessie A Elliott; Naomi Fearon; Hans Eckhardt; Janet McCormack; Catherine Godson; Eoin Patrick Brennan; Lars Fandriks; Neil G Docherty; Carel W le Roux Journal: BMJ Open Diabetes Res Care Date: 2020-07