Impact of preconceptional vertical sleeve gastrectomy on metabolic, cardiovascular and hepatic functions of Sprague Dawley female rats and perinatal consequences

Vertical sleeve gastrectomy (VSG) is the most performed metabolic bariatric surgery, and is known to improve fertility, leading to a rise in procedures among women of childbearing age. With an experimental model in Sprague-Dawley rats, we investigated the impact of pre-conceptional VSG on physiological functions of mothers, and its perinatal consequences during pregnancy. Female control rats (Control) received a standard diet, while others were fed a high-fat, high-sugar diet (HFHS). HFHS rats were divided into Obese and Sleeve groups. One month after surgery, all groups underwent gestation and subsequent lactation. Metabolic, cardiovascular and hepatic functions were evaluated 4 months after VSG. From one-month post-surgery, Sleeve mothers showed decreased leptin and insulin levels compared to Obese mothers, normal fertility with similar litter size to Control, without any effect on birth weight of pups Three months later, although body weight and white adipose tissue were also normalized, Sleeve mothers exhibited a high level of hepatic fibrosis and a hypertrophic remodelling of the thoracic aorta. In addition, we detected an endothelial dysfunction of mesenteric arteries, with a stronger involvement of COX/PGI2 pathway in the vasoreactivity. While VSG improves metabolic function at short and middle term after surgery, our results highlight an alteration of hepatic and vascular functions which could lead to cardiovascular diseases.