Muscle adaptation to sleeve gastrectomy: Potential role of nutritional supplementation and physical exercise

Skeletal muscle is metabolically and functionally flexible and contractile under normal conditions. Obesity is a risk factor that causes metabolic disorders and reduces mus-cle contractility. Sleeve gastrectomy (SG) has been used for surgical correction of obesity. This work aimed to in-vestigate how obesity and its surgical correction affects skeletal muscle and the possible role of nutritional sup-plementation and physical exercise. Adult male albino rats were randomly divided into five groups, 8 rats per group: group Ia (control non-obese), group Ib (control obese), group II (post-operative, SG), group III (post SG + nutritional supplementation) and group IV (post SG + nutritional supplementation + physical exercise). SG re-sulted in cellular and metabolic degenerative disorders in the muscle including wasting, weakness and fibrosis with elevated inflammatory, oxidative and injury mark -ers. Nutritional supplementation induced the post SG muscle regeneration indicated by high expression of in-sulin growth factor-1 (IGF-1) and myogenin and low ex-pression of transforming growth factor beta 1 (TGF-beta 1). Interestingly, it improved the metabolic state of the muscle by reducing the oxidative stress, inflammatory and muscle injury markers and delaying the onset of fa-tigue. What is more, physical exercise along with nutri-tional supplementation resulted in further improvement of the muscle metabolic state and function. In conclu-sion, nutritional supplementations together with physi-cal exercise after SG are essential for preserving muscle mass and contractility and improving its metabolic and functional status.