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Published in: Obesity Surgery 12/2018

01-12-2018 | Original Contributions

Intestinal Glucose Absorption Was Reduced by Vertical Sleeve Gastrectomy via Decreased Gastric Leptin Secretion

Authors: Jinpeng Du, Chaojie Hu, Jie Bai, Miaomiao Peng, Qingbo Wang, Ning Zhao, Yu Wang, Guobin Wang, Kaixiong Tao, Geng Wang, Zefeng Xia

Published in: Obesity Surgery | Issue 12/2018

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Abstract

Background

The unique effects of gastric resection after vertical sleeve gastrectomy (VSG) on type 2 diabetes mellitus remain unclear. This work aimed to investigate the effects of VSG on gastric leptin expression and intestinal glucose absorption in high-fat diet-induced obesity.

Methods

Male C57BL/6J mice were fed a high-fat diet (HFD) to induce obesity. HFD mice were randomized into VSG and sham-operation groups, and the relevant parameters were measured at 8 weeks postoperation.

Results

Higher gastric leptin expression and increased intestinal glucose transport were observed in the HFD mice. Furthermore, VSG reduced gastric leptin expression and the intestinal absorption of alimentary glucose. Both exogenous leptin replenishment during the oral glucose tolerance test (OGTT) and the addition of leptin into the everted isolated jejunum loops in vitro restored the glucose transport capacity in VSG-operated mice, and this effect was abolished when the glucose transporter GLUT2 was blocked with phloretin. Moreover, phloretin almost completely suppressed glucose transport in the HFD mice. Intestinal immunohistochemistry in the obese mice showed increased GLUT2 and diminished sodium glucose co-transporter 1 (SGLT-1) in the apical membrane of enterocytes. Decreased GLUT2 and enhanced SGLT1 were observed following VSG. VSG also reduced the phosphorylation status of protein kinase C isoenzyme β II (PKCβ II) in the jejunum, which was stimulated by the combination of leptin and glucose.

Conclusion

Our data demonstrated that the decreased secretion of gastric leptin in VSG results in a decrease in intestinal glucose absorption via modulation of GLUT2 translocation.
Appendix
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Literature
1.
go back to reference Brito JP, Montori VM, Davis AM. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. JAMA. 2017;317(6):635–6.CrossRef Brito JP, Montori VM, Davis AM. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. JAMA. 2017;317(6):635–6.CrossRef
2.
go back to reference Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRef Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRef
3.
go back to reference Cavin JB, Bado A, Le Gall M. Intestinal adaptations after bariatric surgery: consequences on glucose homeostasis. Trends Endocrinol Metab. 2017;28(5):354–64.CrossRef Cavin JB, Bado A, Le Gall M. Intestinal adaptations after bariatric surgery: consequences on glucose homeostasis. Trends Endocrinol Metab. 2017;28(5):354–64.CrossRef
4.
go back to reference Rosenthal RJ, Diaz AA, Arvidsson D, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.CrossRef Rosenthal RJ, Diaz AA, Arvidsson D, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.CrossRef
5.
go back to reference Cho YM. A gut feeling to cure diabetes: potential mechanisms of diabetes remission after bariatric surgery. Diabetes Metab J. 2014;38(6):406–15.CrossRef Cho YM. A gut feeling to cure diabetes: potential mechanisms of diabetes remission after bariatric surgery. Diabetes Metab J. 2014;38(6):406–15.CrossRef
6.
go back to reference Ryan KK, Tremaroli V, Clemmensen C, et al. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature. 2014;509(7499):183–8.CrossRef Ryan KK, Tremaroli V, Clemmensen C, et al. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature. 2014;509(7499):183–8.CrossRef
7.
go back to reference Bueter M, Lowenstein C, Olbers T, et al. Gastric bypass increases energy expenditure in rats. Gastroenterology. 2010;138(5):1845–53.CrossRef Bueter M, Lowenstein C, Olbers T, et al. Gastric bypass increases energy expenditure in rats. Gastroenterology. 2010;138(5):1845–53.CrossRef
8.
go back to reference le Roux CW, Borg C, Wallis K, et al. Gut hypertrophy after gastric bypass is associated with increased glucagon-like peptide 2 and intestinal crypt cell proliferation. Ann Surg. 2010;252(1):50–6.CrossRef le Roux CW, Borg C, Wallis K, et al. Gut hypertrophy after gastric bypass is associated with increased glucagon-like peptide 2 and intestinal crypt cell proliferation. Ann Surg. 2010;252(1):50–6.CrossRef
9.
go back to reference Saeidi N, Meoli L, Nestoridi E, et al. Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science (New York, NY). 2013;341(6144):406–10.CrossRef Saeidi N, Meoli L, Nestoridi E, et al. Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science (New York, NY). 2013;341(6144):406–10.CrossRef
10.
go back to reference Cavin JB, Couvelard A, Lebtahi R, Ducroc R, Arapis K, Voitellier E, Cluzeaud F, Gillard L, Hourseau M, Mikail N, Ribeiro-Parenti L, Kapel N, Marmuse JP, Bado A, le Gall M Differences in alimentary glucose absorption and intestinal disposal of blood glucose after roux-en-Y gastric bypass vs sleeve gastrectomy. Gastroenterology 2016, 150(2):454–64.e9, 464.e9.CrossRef Cavin JB, Couvelard A, Lebtahi R, Ducroc R, Arapis K, Voitellier E, Cluzeaud F, Gillard L, Hourseau M, Mikail N, Ribeiro-Parenti L, Kapel N, Marmuse JP, Bado A, le Gall M Differences in alimentary glucose absorption and intestinal disposal of blood glucose after roux-en-Y gastric bypass vs sleeve gastrectomy. Gastroenterology 2016, 150(2):454–64.e9, 464.e9.CrossRef
11.
go back to reference Mumphrey MB, Hao Z, Townsend RL, et al. Sleeve gastrectomy does not cause hypertrophy and reprogramming of intestinal glucose metabolism in rats. Obes Surg. 2015;25(8):1468–73.CrossRef Mumphrey MB, Hao Z, Townsend RL, et al. Sleeve gastrectomy does not cause hypertrophy and reprogramming of intestinal glucose metabolism in rats. Obes Surg. 2015;25(8):1468–73.CrossRef
12.
go back to reference Myers Jr MG, Olson DP. Central nervous system control of metabolism. Nature. 2012;491(7424):357–63.CrossRef Myers Jr MG, Olson DP. Central nervous system control of metabolism. Nature. 2012;491(7424):357–63.CrossRef
13.
go back to reference Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin. Nature. 1998;394(6695):790–3.CrossRef Bado A, Levasseur S, Attoub S, et al. The stomach is a source of leptin. Nature. 1998;394(6695):790–3.CrossRef
14.
go back to reference Sobhani I, Bado A, Vissuzaine C, et al. Leptin secretion and leptin receptor in the human stomach. Gut. 2000;47(2):178–83.CrossRef Sobhani I, Bado A, Vissuzaine C, et al. Leptin secretion and leptin receptor in the human stomach. Gut. 2000;47(2):178–83.CrossRef
15.
go back to reference Ducroc R, Guilmeau S, Akasbi K, et al. Luminal leptin induces rapid inhibition of active intestinal absorption of glucose mediated by sodium-glucose cotransporter 1. Diabetes. 2005;54(2):348–54.CrossRef Ducroc R, Guilmeau S, Akasbi K, et al. Luminal leptin induces rapid inhibition of active intestinal absorption of glucose mediated by sodium-glucose cotransporter 1. Diabetes. 2005;54(2):348–54.CrossRef
16.
go back to reference Sakar Y, Nazaret C, Letteron P, et al. Positive regulatory control loop between gut leptin and intestinal GLUT2/GLUT5 transporters links to hepatic metabolic functions in rodents. PLoS One. 2009;4(11):e7935.CrossRef Sakar Y, Nazaret C, Letteron P, et al. Positive regulatory control loop between gut leptin and intestinal GLUT2/GLUT5 transporters links to hepatic metabolic functions in rodents. PLoS One. 2009;4(11):e7935.CrossRef
17.
go back to reference Barrenetxe J, Villaro AC, Guembe L, et al. Distribution of the long leptin receptor isoform in brush border, basolateral membrane, and cytoplasm of enterocytes. Gut. 2002;50(6):797–802.CrossRef Barrenetxe J, Villaro AC, Guembe L, et al. Distribution of the long leptin receptor isoform in brush border, basolateral membrane, and cytoplasm of enterocytes. Gut. 2002;50(6):797–802.CrossRef
18.
go back to reference Buyse M, Sitaraman SV, Liu X, et al. Luminal leptin enhances CD147/MCT-1-mediated uptake of butyrate in the human intestinal cell line Caco2-BBE. J Biol Chem. 2002;277(31):28182–90.CrossRef Buyse M, Sitaraman SV, Liu X, et al. Luminal leptin enhances CD147/MCT-1-mediated uptake of butyrate in the human intestinal cell line Caco2-BBE. J Biol Chem. 2002;277(31):28182–90.CrossRef
19.
go back to reference Buyse M, Berlioz F, Guilmeau S, et al. PepT1-mediated epithelial transport of dipeptides and cephalexin is enhanced by luminal leptin in the small intestine. J Clin Invest. 2001;108(10):1483–94.CrossRef Buyse M, Berlioz F, Guilmeau S, et al. PepT1-mediated epithelial transport of dipeptides and cephalexin is enhanced by luminal leptin in the small intestine. J Clin Invest. 2001;108(10):1483–94.CrossRef
20.
go back to reference Tavernier A, Cavin JB, Le Gall M, et al. Intestinal deletion of leptin signaling alters activity of nutrient transporters and delayed the onset of obesity in mice. FASEB J. 2014;28(9):4100–10.CrossRef Tavernier A, Cavin JB, Le Gall M, et al. Intestinal deletion of leptin signaling alters activity of nutrient transporters and delayed the onset of obesity in mice. FASEB J. 2014;28(9):4100–10.CrossRef
21.
go back to reference Andrikopoulos S, Blair AR, Deluca N, et al. Evaluating the glucose tolerance test in mice. Am J Physiol Endocrinol Metab. 2008;295(6):E1323–32.CrossRef Andrikopoulos S, Blair AR, Deluca N, et al. Evaluating the glucose tolerance test in mice. Am J Physiol Endocrinol Metab. 2008;295(6):E1323–32.CrossRef
22.
go back to reference Xia Z, Wang G, Li H, et al. Influence of bariatric surgery on the expression of nesfatin-1 in rats with type 2 diabetes mellitus. Curr Pharm Des. 2015;21(11):1464–71.CrossRef Xia Z, Wang G, Li H, et al. Influence of bariatric surgery on the expression of nesfatin-1 in rats with type 2 diabetes mellitus. Curr Pharm Des. 2015;21(11):1464–71.CrossRef
23.
go back to reference Guilmeau S, Buyse M, Tsocas A, et al. Duodenal leptin stimulates cholecystokinin secretion: evidence of a positive leptin-cholecystokinin feedback loop. Diabetes. 2003;52(7):1664–72.CrossRef Guilmeau S, Buyse M, Tsocas A, et al. Duodenal leptin stimulates cholecystokinin secretion: evidence of a positive leptin-cholecystokinin feedback loop. Diabetes. 2003;52(7):1664–72.CrossRef
24.
go back to reference Du JP, Wang G, Hu CJ, et al. IFN-gamma secretion in gut of Ob/Ob mice after vertical sleeve gastrectomy and its function in weight loss mechanism. J Huazhong Univ Sci Technolog Med Sci. 2016;36(3):377–82.CrossRef Du JP, Wang G, Hu CJ, et al. IFN-gamma secretion in gut of Ob/Ob mice after vertical sleeve gastrectomy and its function in weight loss mechanism. J Huazhong Univ Sci Technolog Med Sci. 2016;36(3):377–82.CrossRef
25.
go back to reference Kellett GL. The facilitated component of intestinal glucose absorption. J Physiol. 2001;531(Pt 3):585–95.CrossRef Kellett GL. The facilitated component of intestinal glucose absorption. J Physiol. 2001;531(Pt 3):585–95.CrossRef
26.
go back to reference Kellett GL, Helliwell PA. The diffusive component of intestinal glucose absorption is mediated by the glucose-induced recruitment of GLUT2 to the brush-border membrane. Biochem J. 2000;350(Pt 1):155–62.CrossRef Kellett GL, Helliwell PA. The diffusive component of intestinal glucose absorption is mediated by the glucose-induced recruitment of GLUT2 to the brush-border membrane. Biochem J. 2000;350(Pt 1):155–62.CrossRef
27.
go back to reference Cammisotto P, Bendayan M. A review on gastric leptin: the exocrine secretion of a gastric hormone. Anat Cell Biol. 2012;45(1):1–16.CrossRef Cammisotto P, Bendayan M. A review on gastric leptin: the exocrine secretion of a gastric hormone. Anat Cell Biol. 2012;45(1):1–16.CrossRef
28.
go back to reference Le Beyec J, Pelletier AL, Arapis K, et al. Overexpression of gastric leptin precedes adipocyte leptin during high-fat diet and is linked to 5HT-containing enterochromaffin cells. Int J Obes (2005). 2014;38(10):1357–64.CrossRef Le Beyec J, Pelletier AL, Arapis K, et al. Overexpression of gastric leptin precedes adipocyte leptin during high-fat diet and is linked to 5HT-containing enterochromaffin cells. Int J Obes (2005). 2014;38(10):1357–64.CrossRef
29.
go back to reference Jimenez A, Ceriello A, Casamitjana R, et al. Remission of type 2 diabetes after roux-en-Y gastric bypass or sleeve gastrectomy is associated with a distinct glycemic profile. Ann Surg. 2015;261(2):316–22.CrossRef Jimenez A, Ceriello A, Casamitjana R, et al. Remission of type 2 diabetes after roux-en-Y gastric bypass or sleeve gastrectomy is associated with a distinct glycemic profile. Ann Surg. 2015;261(2):316–22.CrossRef
30.
go back to reference Le Gall M, Tobin V, Stolarczyk E, et al. Sugar sensing by enterocytes combines polarity, membrane bound detectors and sugar metabolism. J Cell Physiol. 2007;213(3):834–43.CrossRef Le Gall M, Tobin V, Stolarczyk E, et al. Sugar sensing by enterocytes combines polarity, membrane bound detectors and sugar metabolism. J Cell Physiol. 2007;213(3):834–43.CrossRef
31.
go back to reference Lehmann A, Hornby PJ. Intestinal SGLT1 in metabolic health and disease. Am J Physiol Gastrointest Liver Physiol. 2016;310(11):G887–98.CrossRef Lehmann A, Hornby PJ. Intestinal SGLT1 in metabolic health and disease. Am J Physiol Gastrointest Liver Physiol. 2016;310(11):G887–98.CrossRef
32.
go back to reference Kellett GL, Brot-Laroche E. Apical GLUT2: a major pathway of intestinal sugar absorption. Diabetes. 2005;54(10):3056–62.CrossRef Kellett GL, Brot-Laroche E. Apical GLUT2: a major pathway of intestinal sugar absorption. Diabetes. 2005;54(10):3056–62.CrossRef
33.
go back to reference Ait-Omar A, Monteiro-Sepulveda M, Poitou C, et al. GLUT2 accumulation in enterocyte apical and intracellular membranes: a study in morbidly obese human subjects and Ob/Ob and high fat-fed mice. Diabetes. 2011;60(10):2598–607.CrossRef Ait-Omar A, Monteiro-Sepulveda M, Poitou C, et al. GLUT2 accumulation in enterocyte apical and intracellular membranes: a study in morbidly obese human subjects and Ob/Ob and high fat-fed mice. Diabetes. 2011;60(10):2598–607.CrossRef
34.
go back to reference Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.CrossRef Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.CrossRef
35.
go back to reference Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy--a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–8.CrossRef Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy--a prospective randomized trial. Surg Obes Relat Dis. 2011;7(5):561–8.CrossRef
36.
go back to reference Chambers AP, Smith EP, Begg DP, et al. Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy. Am J Physiol Endocrinol Metab. 2014;306(4):E424–32.CrossRef Chambers AP, Smith EP, Begg DP, et al. Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy. Am J Physiol Endocrinol Metab. 2014;306(4):E424–32.CrossRef
37.
go back to reference Valderas JP, Irribarra V, Rubio L, et al. Effects of sleeve gastrectomy and medical treatment for obesity on glucagon-like peptide 1 levels and glucose homeostasis in non-diabetic subjects. Obes Surg. 2011;21(7):902–9.CrossRef Valderas JP, Irribarra V, Rubio L, et al. Effects of sleeve gastrectomy and medical treatment for obesity on glucagon-like peptide 1 levels and glucose homeostasis in non-diabetic subjects. Obes Surg. 2011;21(7):902–9.CrossRef
38.
go back to reference Romero F, Nicolau J, Flores L, et al. Comparable early changes in gastrointestinal hormones after sleeve gastrectomy and roux-En-Y gastric bypass surgery for morbidly obese type 2 diabetic subjects. Surg Endosc. 2012;26(8):2231–9.CrossRef Romero F, Nicolau J, Flores L, et al. Comparable early changes in gastrointestinal hormones after sleeve gastrectomy and roux-En-Y gastric bypass surgery for morbidly obese type 2 diabetic subjects. Surg Endosc. 2012;26(8):2231–9.CrossRef
39.
go back to reference Jimenez A, Mari A, Casamitjana R, et al. GLP-1 and glucose tolerance after sleeve gastrectomy in morbidly obese subjects with type 2 diabetes. Diabetes. 2014;63(10):3372–7.CrossRef Jimenez A, Mari A, Casamitjana R, et al. GLP-1 and glucose tolerance after sleeve gastrectomy in morbidly obese subjects with type 2 diabetes. Diabetes. 2014;63(10):3372–7.CrossRef
40.
go back to reference Ye J, Hao Z, Mumphrey MB, et al. GLP-1 receptor signaling is not required for reduced body weight after RYGB in rodents. Am J Physiol Regul Integr Comp Physiol. 2014;306(5):R352–62.CrossRef Ye J, Hao Z, Mumphrey MB, et al. GLP-1 receptor signaling is not required for reduced body weight after RYGB in rodents. Am J Physiol Regul Integr Comp Physiol. 2014;306(5):R352–62.CrossRef
41.
go back to reference Wilson-Perez HE, Chambers AP, Ryan KK, et al. Vertical sleeve gastrectomy is effective in two genetic mouse models of glucagon-like peptide 1 receptor deficiency. Diabetes. 2013;62(7):2380–5.CrossRef Wilson-Perez HE, Chambers AP, Ryan KK, et al. Vertical sleeve gastrectomy is effective in two genetic mouse models of glucagon-like peptide 1 receptor deficiency. Diabetes. 2013;62(7):2380–5.CrossRef
42.
go back to reference Rodriguez A, Becerril S, Valenti V, et al. Short-term effects of sleeve gastrectomy and caloric restriction on blood pressure in diet-induced obese rats. Obes Surg. 2012;22(9):1481–90.CrossRef Rodriguez A, Becerril S, Valenti V, et al. Short-term effects of sleeve gastrectomy and caloric restriction on blood pressure in diet-induced obese rats. Obes Surg. 2012;22(9):1481–90.CrossRef
43.
go back to reference Myronovych A, Kirby M, Ryan KK, et al. Vertical sleeve gastrectomy reduces hepatic steatosis while increasing serum bile acids in a weight-loss-independent manner. Obesity (Silver Spring, Md). 2014;22(2):390–400.CrossRef Myronovych A, Kirby M, Ryan KK, et al. Vertical sleeve gastrectomy reduces hepatic steatosis while increasing serum bile acids in a weight-loss-independent manner. Obesity (Silver Spring, Md). 2014;22(2):390–400.CrossRef
44.
go back to reference Patti ME, Houten SM, Bianco AC, et al. Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity (Silver Spring, Md). 2009;17(9):1671–7.CrossRef Patti ME, Houten SM, Bianco AC, et al. Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity (Silver Spring, Md). 2009;17(9):1671–7.CrossRef
45.
go back to reference Belgaumkar AP, Vincent RP, Carswell KA, et al. Changes in bile acid profile after laparoscopic sleeve gastrectomy are associated with improvements in metabolic profile and fatty liver disease. Obes Surg. 2016;26(6):1195–202.CrossRef Belgaumkar AP, Vincent RP, Carswell KA, et al. Changes in bile acid profile after laparoscopic sleeve gastrectomy are associated with improvements in metabolic profile and fatty liver disease. Obes Surg. 2016;26(6):1195–202.CrossRef
46.
go back to reference Ma Y, Huang Y, Yan L, et al. Synthetic FXR agonist GW4064 prevents diet-induced hepatic steatosis and insulin resistance. Pharm Res. 2013;30(5):1447–57.CrossRef Ma Y, Huang Y, Yan L, et al. Synthetic FXR agonist GW4064 prevents diet-induced hepatic steatosis and insulin resistance. Pharm Res. 2013;30(5):1447–57.CrossRef
47.
go back to reference Fang S, Suh JM, Reilly SM, et al. Intestinal FXR agonism promotes adipose tissue browning and reduces obesity and insulin resistance. Nat Med. 2015;21(2):159–65.CrossRef Fang S, Suh JM, Reilly SM, et al. Intestinal FXR agonism promotes adipose tissue browning and reduces obesity and insulin resistance. Nat Med. 2015;21(2):159–65.CrossRef
48.
go back to reference Liang CP, Tall AR. Transcriptional profiling reveals global defects in energy metabolism, lipoprotein, and bile acid synthesis and transport with reversal by leptin treatment in Ob/Ob mouse liver. J Biol Chem. 2001;276(52):49066–76.CrossRef Liang CP, Tall AR. Transcriptional profiling reveals global defects in energy metabolism, lipoprotein, and bile acid synthesis and transport with reversal by leptin treatment in Ob/Ob mouse liver. J Biol Chem. 2001;276(52):49066–76.CrossRef
Metadata
Title
Intestinal Glucose Absorption Was Reduced by Vertical Sleeve Gastrectomy via Decreased Gastric Leptin Secretion
Authors
Jinpeng Du
Chaojie Hu
Jie Bai
Miaomiao Peng
Qingbo Wang
Ning Zhao
Yu Wang
Guobin Wang
Kaixiong Tao
Geng Wang
Zefeng Xia
Publication date
01-12-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3351-4

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