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Bariatric Surgery

Sleeve gastrectomy ameliorates alveolar structures and surfactant protein expression in lungs of obese and diabetic rats

International Journal of Obesity volume 44, pages 2394–2404 (2020)Cite this article

Subjects

Abstract

Background

Bariatric surgeries have been shown to be effective in reversing damaged pulmonary function in individuals suffering from obesity and type 2 diabetes mellitus, whereas its underlying mechanisms remain largely unknown.

Methods

Sleeve gastrectomy (SG) was performed on obese and diabetic Wistar rats, and their pulmonary function and lung tissues were compared to sham-operated (SH) obese and diabetic rats, and age-matched healthy controls (C) to explore the improvements in microstructures and expression of surfactant protein (SP)-A and -C at postoperative 4th, 8th, and 12th week.

Result

Apart from the profound metabolic changes and improvement in pulmonary function, lung volume was restored along with an improved diffusion capacity noted by thinned capillary basement membrane and decreased harmonic mean length of diffusion barrier in SG rats. The digital slices of light microscope showed the general changes brought on by the SG, including normalized basic structures, ameliorated inflammatory status, as well as reduced lipid deposition, where the hydroxyproline (HYP), triglyceride (TG) assays, and electron microscope further suggested that the improvement in alveolar structures lies in reduced collagen fibers, lipids and septal tissues, increased capillary blood, and normalized alveolar type 2 (AT2) cells. Besides, disrupted SP-A and SP-C expression were also normalized after SG.

Conclusion

The improvement of lung function after SG is related to the ameliorated alveolar structures, and surface protein expression induced by weight loss and improved glucose metabolism.

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Fig. 1: Comparisons of metabolic parameters.
Fig. 2: Alterations of basic morphology and tissue properties of lungs under LM.
Fig. 3: Representative microstructures of lungs at the postoperative week 12 under EM.
Fig. 4: The positive effect of SG on tissue property, lung volume, alveolar structures and the morphology of AT2 cells.
Fig. 5: The representative bands of SP-A and SP-C and comparison of relative intensity among groups.

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Data availability

Research data of current study is available at R.R., J.L., Q.X., M.Z., Y.X., Z.Y., J.Z., Y.C., Z.M., S.H., G.Z. (2020), “Data for: Sleeve gastrectomy ameliorates alveolar structures and surfactant protein expression in lungs of obese and diabetic rats”, Mendeley Data, V2, https://doi.org/10.17632/5nn793z99j.2.

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Acknowledgements

This project was supported by the National Natural Science Foundation of China (NSFC, Grant Nos 81370496 and 81873647) and Youth Program of National Natural Science Foundation of China (Grant No. 81600059)

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Authors and Affiliations

  1. Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, 250014, People’s Republic of China

    Rexiati Ruze, Qian Xu & Yacheng Xiong

  2. Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, People’s Republic of China

    Jianwen Li

  3. Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, 250014, People’s Republic of China

    Mingwei Zhong, Jiankang Zhu, Yugang Cheng, Zhe Ma, Sanyuan Hu & Guangyong Zhang

  4. Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, 250012, People’s Republic of China

    Zhibo Yan

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Contributions

G.Z. and J.L. conceived the experiments. G.Z., Z.Y., and J.Z. designed the experiment. Q.X. and M.Z. did the literature research. R.R. and Y.X. carried out the experiment. Y.C. and Z.M. performed the statistical analysis. Manuscript was prepared by R.R. S.H. and G.Z. had the final approval of the submitted and published version.

Corresponding author

Correspondence to Guangyong Zhang.

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The authors declare that they have no conflict of interest.

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All study protocols were approved by the Animal Care and Utilization Committee of Shandong University.

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Ruze, R., Li, J., Xu, Q. et al. Sleeve gastrectomy ameliorates alveolar structures and surfactant protein expression in lungs of obese and diabetic rats. Int J Obes 44, 2394–2404 (2020). https://doi.org/10.1038/s41366-020-0647-y

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