Improved Rodent Maternal Metabolism But Reduced Intrauterine Growth After Vertical Sleeve Gastrectomy

Despite improved rodent maternal metabolism after vertical sleeve gastrectomy, offspring of dams after surgery show intrauterine growth restriction. Affecting the Next Generation Long-term weight loss is increasingly achieved through surgical means, and the vast majority of recipients of these surgeries are female. However, limited work has been done evaluating the effects of maternal bariatric surgery on offspring born after surgically induced weight loss. Using a rodent model of bariatric surgery called vertical sleeve gastrectomy (VSG), Grayson and colleagues now show metabolic improvements to female rats after VSG. These improvements included loss of body weight and body fat, as well as improved glucose tolerance and reduced circulating lipids. After body weight and food intake stabilization, the investigators mated female rats, and the metabolic parameters of the offspring were evaluated. Offspring born to VSG-operated females showed intrauterine growth restriction. When the VSG-operated mothers were maintained on a palatable high-fat diet during pregnancy and lactation, the offspring at weaning became glucose-intolerant in comparison to offspring of sham-operated controls and exhibited fatty livers and had greater adiposity similar to offspring of obese sham-operated control mothers. If switched to a low-fat diet from weaning to adulthood, no detectable differences were observed in the offspring of VSG-operated mothers and sham-operated control mothers. When further challenged with a palatable high-fat diet later in life, the offspring of VSG-operated animals exhibited marked adiposity and were glucose-intolerant, surpassing that of offspring born to obese dams. Collectively, these data suggest that the beneficial improvements of maternal surgical weight loss may not be uniformly beneficial for their offspring. Obesity has profound negative consequences on female reproduction as well as on the metabolic health of offspring. Bariatric surgery is the most effective method for sustained weight loss. A critical question is whether bariatric surgery can reverse the deleterious effects of obesity on both female reproduction and subsequent offspring. Vertical sleeve gastrectomy (VSG) is a bariatric procedure rapidly growing in popularity because it provides weight loss and other metabolic benefits that are comparable to those offered by the more complicated Roux-en-Y gastric bypass (RYGB). Female rats rendered obese on a high-fat diet (HFD) underwent either VSG or sham surgery. Like their male counterparts, females had significant metabolic improvements including reduced adiposity and improved glucose tolerance. After VSG, female rats showed a more normal reproductive cycle. Despite these maternal benefits, the offspring of dams receiving VSG were born smaller and lighter than offspring of control dams that underwent sham surgery. When maintained on an HFD after puberty, these adult offspring had a greater propensity to develop glucose intolerance and increased adiposity than the offspring of lean mothers or obese mothers who underwent sham surgery. These data suggest that weight loss alone by obese mothers is not sufficient to reverse the deleterious effects of an HFD and obesity on their offspring.