Metabolic comparison of one-anastomosis gastric bypass, single-anastomosis duodenal-switch, Roux-en-Y gastric bypass, and vertical sleeve gastrectomy.

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Metabolic comparison of one-anastomosis gastric bypass, single-anastomosis duodenal-switch, Roux-en-Y gastric bypass, and vertical sleeve gastrectomy in rat Deanna M. Arble, Ph.D., Simon S. Evers, Ph.D., Nadejda Bozadjieva, Ph.D., Henriette Frikke-Schmidt, Ph.D., Andriy Myronovych, M.D., Ph.D., Alfor Lewis, Ph.D., Mouhamadoul Habib Toure, D.V.M., Randy J. Seeley, Ph.D. Surgery for Obesity and Related Diseases Volume 14, Issue 12, Pages 1857-1867 (December 2018) DOI: 10.1016/j.soard.2018.08.019 Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 1 Surgical effect on body mass and body composition. (A) Absolute weight changes (in g) after surgery. *All groups differ from sham; †one-anastomosis gastric bypass, Roux-en-Y gastric bypass, and single-anastomosis duodenal switch differ from sham. (B) Percent change from baseline weight after surgery. *All groups differ from sham; †one-anastomosis gastric bypass, Roux-en-Y gastric bypass, and single-anastomosis duodenal switch differ from sham. (C) Absolute change in fat mass 15 weeks postsurgery. ****Significant difference from Sham, P < .0001. (D) Absolute change in lean mass 15 weeks postsurgery. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 2 Surgical effect on food intake. (A) Cumulative caloric intake from surgical recovery to 14 weeks postsurgery. **Significant difference from sham, P < .01 (B) Weekly caloric intakes of each surgical group; *All groups differ from sham; †one-anastomosis gastric bypass and sleeve gastrectomy differ from sham. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 3 Surgical effect on glucose regulation. (A) Fasting blood glucose levels. *Significant difference from sham, P < .05. (B) Glucose response to an oral mixed-meal tolerance test. *Significant difference from sham, P < .05. (C) Baseline/fasting plasma insulin levels and plasma insulin 15 minutes after an oral mixed meal. *Significant difference from sham at same time point, P < .05, **P < .01, ****P < .0001. (D) Total glucagon-like protein-1 response to an oral mixed-meal tolerance test. *All groups significant difference from sham, P < .05. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 4 Surgical effect on lipid regulation. (A) Plasma cholesterol levels. **Significant difference from sham, P < .01. (B) Plasma free fatty acids (FFA). (C) Plasma triglycerides. *Significant difference from sham, P < .05, **P < .01. (D) Liver triglycerides expressed as milligram per gram of liver tissue. ***Significant difference from sham, P < .001, ****P < .0001. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 5 Surgical effect on iron regulation. (A) Total circulating iron levels. *Significant difference from sham, P < .05, **P < .01, ***P < .001. (B) Hematocrit levels, *Significant difference from sham, P < .05, **P < .01, ****P < .0001. (C) Reticulocyte count. *Significant difference from sham, P < .05. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 6 Surgical effect on the fecal microbiome. (A) There were significant differences in the microbiota of most surgical groups, as calculated by measuring the distance between communities (θYC). Only sleeve gastrectomy versus sham was found to be similar in microbiome population. (B) No significant differences were observed in microbiome diversity as calculated using the inverse Simpson measure. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions

Fig. 7 Summary of surgical procedures and their major effects on metabolism. Surgery for Obesity and Related Diseases 2018 14, 1857-1867DOI: (10.1016/j.soard.2018.08.019) Copyright © 2018 American Society for Bariatric Surgery Terms and Conditions