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Aims/Introduction  Duodenal‐jejunal bypass ( DJB ) surgery has been reported to effectively relieve diabetic cardiomyopathy ( DCM ). However, the specific mechanisms remain largely unknown. The present study was designed to determine the alterations of myocardial glucose uptake ( MGU ) after  DJB  and their effects on  DCM .    Materials and Methods  Duodenal‐jejunal bypass and sham surgeries were carried out in diabetic rats induced by a high‐fat diet and a low dose of streptozotocin, with chow‐diet fed rats as controls. Bodyweight, food intake, glucose homeostasis and lipid profiles were measured at indicated time‐points. Cardiac function was evaluated by transthoracic echocardiography and hemodynamic measurement. Cardiac remodeling was assessed by a series of morphometric analyses along with transmission electron microscopy. Positron‐emission tomography with fluorine‐18 labeled fluorodeoxyglucose was carried out to evaluate the  MGU   in vivo . Furthermore, myocardial glucose transporters ( GLUT; GLUT 1 and  GLUT 4), myocardial insulin signaling and  GLUT ‐4 translocation‐related proteins were investigated to elucidate the underlying mechanisms.    Results  The  DJB  group showed restored systolic and diastolic cardiac function, along with significant remission in cardiac hypertrophy, cardiac fibrosis, lipid deposit and ultrastructural disorder independent of weight loss compared with the sham group. Furthermore, the  DJB  group showed upregulated myocardial insulin signaling, hyperphosphorylation of  AKT  substrate of 160  kD a ( AS 160) and  TBC 1D1, along with preserved  soluble N‐ethylmaleimide‐sensitive factor attachment protein receptor  proteins, facilitating the  GLUT ‐4 translocation to the myocardial cell surface and restoration of  MGU .    Conclusions  The present findings provide evidence that restoration of  MGU  is implicated in the alleviation of  DCM  after  DJB  through facilitating  GLUT ‐4 translocation, suggesting a potential choice for treatment of human  DCM  if properly implemented.

journal of diabetes investigation

Restoration of myocardial glucose uptake with facilitated myocardial glucose transporter 4 translocation contributes to alleviation of diabetic cardiomyopathy in rats after duodenal‐jejunal bypass