Inhibition of somatostatin enhances the long-term metabolic outcomes of sleeve gastrectomy in mice

Bariatric surgery is an effective obesity treatment, leading to weight loss and improvement in glycemia, that is characterized by hypersecretion of gastrointestinal hormones. However, weight regain and relapse of hyperglycemia are not uncommon. Here, we investigated the role of somatostatin (Sst) in bariatric surgery outcomes using a mouse model of sleeve gastrectomy (SG). Sst knockout (sst-ko) mice fed with a calorie-rich diet gained weight normally, and had a mild favorable metabolic phenotype compared to heterozygous sibling controls, including elevated plasma levels of Glp1. Mathematical modeling of the feedback inhibition between Sst and Glp1 showed that Sst exerts its maximal effect on Glp1 under conditions of high hormonal stimulation, such as following SG. Obese sst-ko mice that underwent SG had higher levels of Glp1 compared with heterozygous SG-operated controls. Accordingly, SG-sst-ko mice regained less weight than controls and maintained lower glycemia months after surgery. Obese wild-type mice that underwent SG and were treated daily with a Sst receptor inhibitor for two months, had higher Glp1 levels, regained less weight, and improved glycemia compared to saline- treated SG-operated controls. Our results suggest that Sst signaling inhibition enhances and maintains the long-term favorable metabolic outcomes of bariatric surgery.