Sleeve Gastrectomy Attenuates Diabetic Nephropathy by Upregulating Nephrin Expressions in Diabetic Obese Rats
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ORIGINAL CONTRIBUTIONS
Sleeve Gastrectomy Attenuates Diabetic Nephropathy by Upregulating Nephrin Expressions in Diabetic Obese Rats Yacheng Xiong 1 & Wei Zhu 2 & Qian Xu 1 & Rexiati Ruze 1 & Zhibo Yan 3 & Jianwen Li 4 & Sanyuan Hu 5 & Mingwei Zhong 5 & Yugang Cheng 5 & Guangyong Zhang 5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Diabetic nephropathy (DN) is the leading cause of end-stage renal disease, and sleeve gastrectomy (SG) is considered to be an effective strategy to improve pre-existing DN. However, the mechanism remains unknown. Materials and Methods Animal model of DN was induced by high-fat diet (HFD) and streptozotocin (STZ). SG or sham surgery was performed and rats were sacrificed at 4, 8, and 12 weeks after surgery. The basic parameters (blood glucose, body weight, kidney weight), indicators of renal function including serum creatinine (Scr), blood urea nitrogen (BUN), urine microalbumin, urine creatinine (Ucr), microalbumin creatinine ratio (UACR), ultrastructural changes of glomerulus, and the expression of nephrin gene and protein in glomerular podocytes were compared among groups. Results Blood glucose and body weight of SG rats were significantly lower than those of the sham-operated rats, and renal function of SG groups were also significantly improved within the postoperative period of 12 weeks. The results of periodic acidSchiff staining (PAS) and transmission electron microscopy (TEM) showed that glomerular hypertrophy and accumulation of extracellular matrix proteins were significantly alleviated after SG, and the thickness of basement membrane and the fusion or effacement of foot processes were also significantly improved. The mRNA and protein expression of nephrin in SG groups was significantly higher than that in the sham group. Conclusion These results suggest that SG attenuates DN by upregulating the expression of nephrin and improving the ultrastructure of glomerular filtration membrane. This study indicates that SG can be used as an available therapeutic intervention for DN. Keywords Sleeve gastrectomy . Diabetic nephropathy . Nephrin . Glomerular ultrastructure
* Guangyong Zhang [email protected]
Mingwei Zhong [email protected]
Yacheng Xiong [email protected] Wei Zhu [email protected] Qian Xu [email protected] Rexiati Ruze [email protected] Zhibo Yan [email protected] Jianwen Li [email protected] Sanyuan Hu [email protected]
Yugang Cheng [email protected] 1
Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, Shandong Province, People’s Republic of China
2
Shandong Medical College, Jucai 6# Road, Linyi 276000, Shandong Province, People’s Republic of China
3
Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, People’s Republic of China
4
Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
5
Department of G
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