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Department of Physiology, University of California Los Angeles School of Medicine, Los Angeles, California 90095-1751
Intestinal adaptation after resection has
been much studied, but rarely examined in an integrative context. Hence
we assessed the effects of resection and subsequent adaptation on the
quantitative relationship between dietary glucose load and gut capacity
to transport glucose. The ratio of capacity to load is termed the "safety factor." Our objectives were to determine
1) the time course of intestinal
adaptation after resection, 2)
whether adaptation is quantitatively complete,
3) whether survival requires
maintaining a safety factor of at least 1.0 for glucose transport,
4) the effect of altered energy
demands on adaptation, and 5) the
relationship between the amount of tissue removed and the magnitude of
functional adaptation. We performed 80% resection of the small
intestine on Sprague-Dawley rats and measured small intestinal glucose
uptake capacity, dietary glucose load, and gut gross morphology at 1, 5, and 10 wk postsurgery. Nearly all aspects of adaptation were complete by 1 wk postsurgery. After resection, remnant small intestine mass increased by over fivefold within 1 wk, to reach 50-70% of its preresection value. However, mass-specific glucose uptake activity
was reduced, so that intestinal regeneration restored uptake capacity
to only 33% of control values. Increased energetic demands had only
modest effects on intestinal adaptation. Although the safety factor for
small intestinal glucose uptake remained <1.0 (i.e., capacity < load) after adaptation to resection, nearly all rats survived. Hindgut
fermentation of nonabsorbed nutrients appeared to contribute to that
survival, despite inadequate small intestinal capacity. After less
massive resection surgeries (25, 50, and 75% resections), the percent
increase in glucose uptake capacity increased with the amount of tissue removed.
glucose transport; rat; safety factor; survival; time course
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