Duodenal-Jejunal Bypass Surgery in Diet-Induced Obese Diabetic Mice

Summary

Duodenal-jejunal bypass (DJB) surgery can improve glucose metabolism and reduce insulin resistance. Here, we present a protocol to establish a stable and reliable mouse model of DJB.

Abstract

The prevalence of obesity and type 2 diabetes is a serious global health concern. Obesity is a major pathogenic factor in type 2 diabetes, cardiovascular disease, and some cancers. Bariatric surgery offers a long-term and effective treatment option for both obesity and diabetes. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are widely recognized as the most popular bariatric surgeries. Additionally, several exploratory bariatric surgeries have demonstrated promising therapeutic effects. Duodenal-jejunal bypass (DJB), specifically tailored for diabetics with low body mass index, has shown beneficial metabolic outcomes. However, its weight-independent metabolic benefits are not fully understood due to limited animal models. In this article, we describe the optimized care protocols and surgical techniques for performing DJB surgery in diet-induced obese (DIO) diabetic mice. Using a mouse model contributes to a better understanding of the nature of changes induced by DJB surgery while facilitating related clinical practice.

Introduction

Obesity and type 2 diabetes are the most common chronic diseases in the world, and their prevalence is increasing among young individuals¹. Bariatric surgery is the most effective treatment for obesity and diabetes, facilitating long-term blood glucose stabilitywhile also improving the complications associated with obesity^2,3. There are several types of bariatric surgery, classified by whether they reduce gastric volume or intestinal absorption; these include restrictive, malabsorptive, and combination^4,5.

Protocol

All protocol steps described below follow the guidelines of the Animal Care and Use Committee of the General Hospital of the Southern Theater Command under the approval number 2020112501.

1. General preoperative preparation

NOTE: Thirty 6-week-old male C57BL/6 mice were purchased. Mice were housed in a Specific Pathogen-Free (SPF) laboratory under a 12 h light/dark cycle; temperature, 22 ± 2 °C; and humidity, 55-65%. Mice were given free acc.......

Discussion

In 1953, Varco et al.¹⁸ performed the first jejuno-ileal bypass as the beginning of bariatric surgery. Since then, numerous bariatric surgeries have been performed by surgeons. These surgeries have resulted in weight loss and improved metabolic complications^4,19,20. Furthermore, in 1967, Mason and Ito²¹ performed the first Roux-en-Y gastric bypass (RYGB), which can effectively redu.......

Materials

Name	Company	Catalog Number	Comments
Abdominal retractor	F.S.T	17000-03	Colibri Retractor -3cm,retractor range 1.5cm/3cm long
1% sodium pentobarbital solution	Guangzhou Chemical Reagent Factory	/	Dissolved 500mg of pentobarbital sodium powder in 50ml of normal saline to obtain 1% pentobarbital sodium solution.
Benzylpenicillin sodium for Injection	North China Pharmaceutical Company Ltd.	F2062121	Penicillin
Buprenorphine	Guangzhou Chemical Reagent Factory	/	Analgesia
Buprenorphine	Guangzhou Otsuka Pharmaceutical Co., Ltd	/	Analgesic
Citric acid-sodium citrate buffer	LEAGENE	R00522	Buffer solution
Cotton buds	HaoZheng Medical	60220610	Cotton swabs
Depilatory paste	Veet	AAPR-S222	Hair removal cream
Ear tag	ZEYA	SUS304	Ear-mark
Electric blanket	ZOSEN	ZS-CWDRT	Heat pad
Electronic scale	WETTLER TOLEDO	20060902-6	Measure the weight
Enteral nutritional powder	Abbott Laboratories	/	Nutrition powder
Eye ointment	Guangzhou Otsuka Pharmaceutical Co., Ltd	/	Protect the eyes
Glucometer	Roche	6993788001	Assess blood glucose
Graphpad Prism version 9.4.1	GraphPad Software	version 9.4.1	Software for statistical analysis
High-fat diet (High Fat [60FDC] Purified Rodent Diet)	Dyets	112252	60kcal% High Fat Diet
Micro Forceps	Jinzhong Medical	18-1140	Micro forceps
Micro needle holder	Jinzhong Medical	EMT-160-Z	Needle holder
Micro Scissors	Jinzhong Medical	YBC010	Micro scissors
Microscope camera	LAPSUN	E 2000	Video
Ophthalmic scissors	Jinzhong Medical	Y00030	Surgical scissors
Pentobarbital	Guangzhou Chemical Reagent Factory	/	Narcosis
Sodium chloride Injection	Guangzhou Otsuka Pharmaceutical Co., Ltd	B21L0301	NaCl 0.9%
Stereo microscope	ZEISS	Stemi 305	Binocular stereomicroscope
Streptozotocin	Sigma	S110910-1g	STZ
Suture line	LINGQIAO SUTURE	ZS-LQPMRZ5/0	Prolene 6/0,Prolene 10/0
Tissue forceps	Jinzhong Medical	H1701	Surgical forceps