Steatorrhea and Hyperoxaluria Occur after Gastric Bypass Surgery in Obese Rats Regardless of Dietary Fat or Oxalate

Abstract

Purpose

To determine the effect of dietary fat and oxalate on fecal fat excretion and urine parameters in a rat model of Roux-en-Y gastric bypass (RYGB) surgery.

Materials and Methods

Diet-induced obese Sprague–Dawley rats underwent sham (Control, n=16) or RYGB (n=19) surgery. Once recovered, animals were fed ad lib normal calcium, high fat (40%) diet with (Ox) or without (No Ox) 1.5% potassium oxalate for 5 weeks, then normal (10%) fat diet for 2 weeks. Stool and urine were collected after each period. Fecal fat was determined by gas chromatography and urine metabolites by assay spectrophotometry.

Results

Daily fecal fat excretion remained low in controls on either diet. RYGB animals, however, ingested similar food quantity as controls yet had 8-fold higher fecal fat excretion (p<0.001) and heavier stools (p=0.02). On high fat, RYGB Ox had 5-fold increase in urine oxalate excretion (p<0.001) while RYGB No Ox had 2-fold increase in urine calcium (p<0.01) versus controls. Lowering dietary fat in RYGB Ox animals led to a 50% decrease in oxalate excretion (p<0.01), a 30% reduction in urinary calcium, and an increase in urine pH by 0.3 units (p<0.001).

Conclusions

In this RYGB model, high fat feeding resulted in steatorrhea, hyperoxaluria, and low urine pH, partially reversible by lowering dietary fat and oxalate content. RYGB animals on normal fat and no oxalate diets excreted twice as much oxalate as age-matched, sham controls. Although RYGB-hyperoxaluria appears primarily gut and diet-mediated, secondary causes of oxalogenesis from liver or other mechanisms deserve further exploration.

http://www.jurology.com/article/S0022-5347(13)03668-9/abstract