Roux Limb

This group shows that he reprogramming of the roux limb from the surgery makes it a major metabolically active organ for glucose disposal.

Lookahead, NEJM, LIfestyle

Shau,JCEM, DPPIV

Sung, JCEM, Fatty Liver

Chowdhury, Can J Physio Pharm, MIS

1. Stylopoulos,Science, Roux Limb

Reprogramming of Intestinal Glucose Metabolism and Glycemic Control in Rats After Gastric Bypass

1. Nima Saeidi1,2,3,*, 
2. Luca Meoli1,*, 
3. Eirini Nestoridi1,*, 
4. Nitin K. Gupta1, 
5. Stephanie Kvas1, 
6. John Kucharczyk1,
7. Ali A. Bonab2, 
8. Alan J. Fischman2, 
9. Martin L. Yarmush2,3, 
10. Nicholas Stylopoulos1,†

+Author Affiliations

1. ¹Center for Basic and Translational Obesity Research, Division of Endocrinology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
2. ²Shriners Hospital for Children, Boston, MA 02114, USA.
3. ³Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

1. ↵†Corresponding author. E-mail: Nicholas.Stylopoulos@childrens.harvard.edu

1. ↵* These authors contributed equally to this work.

• ABSTRACT
• EDITOR'S SUMMARY

The resolution of type 2 diabetes after Roux-en-Y gastric bypass (RYGB) attests to the important role of the gastrointestinal tract in glucose homeostasis. Previous studies in RYGB-treated rats have shown that the Roux limb displays hyperplasia and hypertrophy. Here, we report that the Roux limb of RYGB-treated rats exhibits reprogramming of intestinal glucose metabolism to meet its increased bioenergetic demands; glucose transporter-1 is up-regulated, basolateral glucose uptake is enhanced, aerobic glycolysis is augmented, and glucose is directed toward metabolic pathways that support tissue growth. We show that reprogramming of intestinal glucose metabolism is triggered by the exposure of the Roux limb to undigested nutrients. We demonstrate by positron emission tomography–computed tomography scanning and biodistribution analysis using 2-deoxy-2-[18F]fluoro-D-glucose that reprogramming of intestinal glucose metabolism renders the intestine a major tissue for glucose disposal, contributing to the improvement in glycemic control after RYGB.