Simulation of gastric bypass effects on glucose metabolism and non-alcoholic fatty liver disease with the Sleeveballoon device

James Casella-Mariolo, Lidia Castagneto-Gissey, Giulia Angelini, Andrea Zoli, Pierluigi Marini, Stefan R. Bornstein, Dimitri J. Pournaras, Francesco Rubino, Carel W. Le Roux, Geltrude Mingrone, Giovanni Casella

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)


Background: Gastric bypass surgery is a very effective treatment of obesity and type 2 diabetes. However, very few eligible patients are offered surgery. Some patients also prefer less invasive approaches. We aimed to study the effects of the Sleeveballoon – a new device combining an intragastric balloon with a connecting sleeve, which covers the duodenal and proximal jejunal mucosa – on insulin sensitivity, glycemic control, body weight and body fat distribution. Methods: We compared the effects of Sleeveballoon, Roux-en-Y Gastric-Bypass (RYGB) and sham-operation in 30 high-fat diet (HFD) fed Wistar rats. Whole body and hepatic insulin sensitivity and insulin signaling were studied. Transthoracic echocardiography was performed using a Vevo 2100 system (FUJIFILM VisualSonics Inc., Canada). Gastric emptying was measured using gastrografin. Findings: Hepatic (P =.023) and whole-body (P =.011) insulin sensitivity improved in the Sleeveballoon and RYGB groups compared with sham-operated rats. Body weight reduced in both Sleeveballoon and RYGB groups in comparison to the sham-operated group (503.1 ± 8.9 vs. 614.4 ± 20.6 g, P =.006 and 490.0 ± 17.7 vs. 614.4 ± 20.6 g, P =.006, respectively). Ectopic fat deposition was drastically reduced while glycogen content was increased in both liver and skeletal muscle. Gastric emptying (T1/2) was longer (157.7 ± 29.2 min, P =.007) in the Sleeveballoon than in sham-operated rats (97.1 ± 26.3 min), but shorter in RYGB (3.5 ± 1.1 min, P <.0001). Cardiac function was better in Sleeveballoon and RYGB versus sham-operated rats. Interpretation: The Sleeveballoon reduces peripheral and hepatic insulin resistance, glycaemia, body weight and ectopic fat deposition to a similar level as RYGB, although the contribution of gastric emptying to blood glucose reduction is different.
Lingua originaleEnglish
pagine (da-a)452-462
Numero di pagine11
Stato di pubblicazionePubblicato - 2019


  • Adiposity
  • Animals
  • Biomarkers
  • Blood Glucose
  • Body Weight
  • Disease Models, Animal
  • Echocardiography
  • Gastric Bypass
  • Gastric Emptying
  • Gastric bypass
  • Gastric emptying
  • Glucose
  • Glucose Tolerance Test
  • Insulin
  • Insulin Resistance
  • Insulin resistance
  • Minimally invasive surgery
  • Non-alcoholic Fatty Liver Disease
  • Obesity
  • Postoperative Care
  • Rats
  • Signal Transduction
  • Type 2 diabetes


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