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The comparison of the intestinal adaptation effects of subcutaneous and oral insulin in a rats with short bowel syndrome


U Bicakci
OK Tuncel
B Bilgici
B Tander
E Ariturk
R Rizalar
O Alici
F Bernay

Abstract

Aim: Insulin has been reported to have positive effects on intestinal adaptation after short bowel syndrome when applicated oral or  subcutaneously. The purpose of this study is to compare the intestinal adaptation effects of subcutaneous and oral routes of insulin in rats with short bowel syndrome.

Materials and Methods: The short bowel syndrome (SBS) was performed through 70-75% of small intestinal resection and an end-to-end  anastomosis. The control group rats underwent SBS only. In the second group, oral insulin (1 U/ml) was administrated twice-daily. In the last group, the insulin was administrated subcutaneously (1 U/kg) as in the control group. All rats were killed on day 15. Outcome parameters were weight of small intestine, the crypt length, villous depth, the blood levels of vascular endothelial growth factor (VEGF), and granolocyt-monocyst colony-stimulating factor (GMCSF).

Results: Intestinal weight was signifi cantly more in oral insulin group and subcutaneous insulin group than in the control group (72.6 ± 4.3, 78.6 ±  4.8 and 59.7 ± 4.8) (P < 0.05). There was no difference between the groups according to villus length, crypt depth, and villous/crypt ratio both in proximal and distal parts of the resected bowel (P > 0.05). VEGF values were not statistically signifi cant between the groups (200.3 ± 41.6, 178.9  ± 30.7 and 184.3 ± 52.2) (P > 0.05). GMCSF was statistically higher in the
control group than in other groups (3.34 ± 1.34, 1.56 ± 0.44 and 1.56 ± 0.44) (P < 0.05).

Conclusion: Insulin has positive effects on intestinal adaptation in short bowel syndrome. Subcutaneous administration is slightly more effective  than the oral route.

Key words: Insulin, intestinal adaptation, short bowel syndrome


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