胃袖状切除术对2型糖尿病大鼠糖脂代谢的调控作用
위수상절제술대2형당뇨병대서당지대사적조공작용
Regulatory effects of sleeve gastrectomy on the glucose and lipid metabolism in rats with type 2 diabetes mellitus
  • 万方数据
    中华消化外科杂志 중화소화외과잡지
    CHINESE JOURNAL OF DIGESTIVE SURGERY
    2014年 7期 551-556 ,共6页

    孙栋%张光永%刘少壮%胡春晓%韩海峰%张翔%李明霞%胡三元

    손동%장광영%류소장%호춘효%한해봉%장상%리명하%호삼원

    糖尿病,2型%胃袖状切除术%大鼠%糖代谢%脂代谢 糖尿病,2型%胃袖狀切除術%大鼠%糖代謝%脂代謝
    당뇨병,2형%위수상절제술%대서%당대사%지대사
    Diabetes mellitus,type 2%Sleeve gastrectomy%Rat%Glucose metabolism%lipid metabolism
    目的 探讨胃袖状切除术对2型糖尿病大鼠糖脂代谢的作用.方法 将24只11周龄的Goto-Kakizaki大鼠按随机数字表法分为空白组(不进行任何手术,仅保持相同进食)、假手术组(仅与手术组对应位置切开缝合)和手术组(胃袖状切除术),每组8只;分别检测各组大鼠各时相点体质量、进食量、糖代谢、激素和脂代谢变化情况.多组比较采用方差分析,两两比较采用LSD检验.结果 术后6周,空白组大鼠体质量、进食量分别为(320±12)g、(25.1±0.8)g,假手术组分别为(318±12)g、(25.5 ±1.3)g,手术组分别为(299±9)g、(21.9±1.3)g,3组比较,差异有统计学意义(F=8.50,10.02,P＜0.05).术后16周,空白组大鼠空腹血糖、葡萄糖耐量试验曲线下面积、胰岛素耐量试验曲线下面积、胰岛素抵抗指数、饥饿素、游离脂肪酸、瘦素分别为(11.4±1.1) mmol/L、(3 220±460) mmol/L·min-1、(2 317±715)mmol/L·min-1、4.2±0.4、(1 513±75) ng/L、(2.16±0.20) μg/L、(6.2±0.8)μg/L,假手术组分别为(12.9±1.3) mmol/L、(3 554±272) mmol/L· min-1、(2 078±367)mmol/L· min-1、4.2±0.8、(1 510±72) ng/L、(1.95±0.31) μg/L、(6.3±0.7) μg/L,手术组分别为(5.5 ±0.3)mmol/L、(2 077±221)mmol/L·min-1、(946±330) mmol/L·min-1、2.2±0.5、(986±75) ng/L、(1.44±0.13) μg/L、(2.5±0.7)μg/L,3组比较,差异有统计学意义(F =84.19,7.33,9.93,18.81,99.79,79.02,238.30,P＜0.05).术后16周葡萄糖灌胃后60 min,空白组大鼠血清胰高血糖素样肽-1、酪酪肽、胰岛素、脂连素分别为(11.3±2.3)pmol/L、(70±13) ng/L、(7.8±1.0)mIU/L、(4.9±1.2) μg/L;假手术组分别为(11.2±1.7) pmol/L、(72±14) ng/L、(9.9±1.9) mIU/L、(5.0±0.9)μg/L;手术组分别为(14.7±2.4) pmol/L、(128±20) ng/L、(21.7±2.1)mIU/L、(7.8±1.1) μg/L,3组比较,差异有统计学意义(F=4.22,20.91,89.17,27.24,P＜0.05).结论 胃袖状切除术能够显著改善2型糖尿病大鼠糖脂代谢紊乱,其作用机制可能与术后胰高血糖素样肽-1、酪酪肽和脂连素的升高,饥饿素、游离脂肪酸和瘦素的降低有关.
    목적 탐토위수상절제술대2형당뇨병대서당지대사적작용.방법 장24지11주령적Goto-Kakizaki대서안수궤수자표법분위공백조(불진행임하수술,부보지상동진식)、가수술조(부여수술조대응위치절개봉합)화수술조(위수상절제술),매조8지;분별검측각조대서각시상점체질량、진식량、당대사、격소화지대사변화정황.다조비교채용방차분석,량량비교채용LSD검험.결과 술후6주,공백조대서체질량、진식량분별위(320±12)g、(25.1±0.8)g,가수술조분별위(318±12)g、(25.5 ±1.3)g,수술조분별위(299±9)g、(21.9±1.3)g,3조비교,차이유통계학의의(F=8.50,10.02,P＜0.05).술후16주,공백조대서공복혈당、포도당내량시험곡선하면적、이도소내량시험곡선하면적、이도소저항지수、기아소、유리지방산、수소분별위(11.4±1.1) mmol/L、(3 220±460) mmol/L·min-1、(2 317±715)mmol/L·min-1、4.2±0.4、(1 513±75) ng/L、(2.16±0.20) μg/L、(6.2±0.8)μg/L,가수술조분별위(12.9±1.3) mmol/L、(3 554±272) mmol/L· min-1、(2 078±367)mmol/L· min-1、4.2±0.8、(1 510±72) ng/L、(1.95±0.31) μg/L、(6.3±0.7) μg/L,수술조분별위(5.5 ±0.3)mmol/L、(2 077±221)mmol/L·min-1、(946±330) mmol/L·min-1、2.2±0.5、(986±75) ng/L、(1.44±0.13) μg/L、(2.5±0.7)μg/L,3조비교,차이유통계학의의(F =84.19,7.33,9.93,18.81,99.79,79.02,238.30,P＜0.05).술후16주포도당관위후60 min,공백조대서혈청이고혈당소양태-1、락락태、이도소、지련소분별위(11.3±2.3)pmol/L、(70±13) ng/L、(7.8±1.0)mIU/L、(4.9±1.2) μg/L;가수술조분별위(11.2±1.7) pmol/L、(72±14) ng/L、(9.9±1.9) mIU/L、(5.0±0.9)μg/L;수술조분별위(14.7±2.4) pmol/L、(128±20) ng/L、(21.7±2.1)mIU/L、(7.8±1.1) μg/L,3조비교,차이유통계학의의(F=4.22,20.91,89.17,27.24,P＜0.05).결론 위수상절제술능구현저개선2형당뇨병대서당지대사문란,기작용궤제가능여술후이고혈당소양태-1、락락태화지련소적승고,기아소、유리지방산화수소적강저유관.
    Objective To investigate the regulatory effects of sleeve gastrectomy on the glucose and lipid metabolism in rats with type 2 diabetes mellitus.Methods Twenty-four Goto-Kakizaki rats aged 11 weeks were randomly divided into the blank group (the rats did not receive any surgical procedures),sham operation group (the rats received abdominal incision and suture at the same site as the rats in the operation group) and operation group (the rats received sleeve gastrectomy).There were 8 rats in each group.The changes of the body weight,food intake,glucose and lipid metabolism and gastrointestinal hormones were measured at different time points after operation.All data were analyzed using the analysis of variance or LSD test.Results In postoperative week 6,the body weights and food intake were decreased to (320 ± 12)g and (25.1 ±0.8)g in the blank group,(318 ± 12)g and (25.5 ± 1.3)g in the sham operation group,(299 ±9)g and (21.9 ± 1.3)g in the operation group.There were significant differences in the body weight and food intake between the 3 groups (F =8.50,10.02,P ＜ 0.05).In postoperative week 16,the levels of fasting glucose,the areas under the curve of the oral glucose tolerance test and insulin tolerance test,index of insulin resistance,ghrelin,free fatty acides and leptin were (11.4 ±1.1) mmol/L,(3 220±460) mmol/L · min-1,(2 317 ±715)mmol/L · min-1,4.2 ±0.4,(1 513 ±75)ng/L,(2.16 ±0.20) μg/L,(6.2 ±0.8) μg/L in the blank group,(12.9 ± 1.3) mmol/L,(3 554 ± 272) mmol/L · min-1,(2 078 ±367) mmol/L · min-1,4.2 ±0.8,(1 510±72)ng/L,(1.95 ± 0.31) μg/L,(6.3 ±0.7)μg/L in the sham operation group,(5.5 ± 0.3) mmol/L,(2 077 ± 221) mmol/L · min-1,(946 ± 330) mmol/L ·min-1,2.2 ± 0.5,(986 ± 75) ng/L,(1.44 ± 0.13) μg/L and (2.5 ± 0.7) μg/L in the operation group.There were significant differences in the fasting glucose,the areas under the curve of the oral glucose tolerance test and insulin tolerance test,index of insulin resistance,ghreliln,free fatty acides and leptin between the 3 groups (F =84.19,7.33,9.93,18.81,99.79,79.02,238.30,P ＜ 0.05).The levels of higher glucagon-like peptide-1 (GLP-1),peptide YY,insulin,adiponectin were (11.3 ± 2.3) pmol/L,(70 ± 13) ng/L,(7.8 ± 1.0) mIU/L,(4.9 ± 1.2) μg/L in the blank group,(11.2 ± 1.7) pmol/L,(72 ± 14) ng/L,(9.9 ± 1.9) mIU/L and (5.0 ±0.9) μg/L in the sham operation group,(14.7 ±2.4)pmol/L,(128 ±20)ng/L,(21.7 ±2.1)mIU/L,(7.8 ±1.1) μg/L in the operation group at 60 minutes after glucose gavage at postoperative week 16.There were significant difference in the levels of GLP-1,peptide YY,insulin,adiponectin between the 3 groups (F =4.22,20.91,89.17,27.24,P ＜ 0.05).Conclusions Sleeve gastrectomy could significantly improve the glucose and lipid metabolic disorder.The mechanism may be related with elevated GLP-1,peptide YY and adiponectin levels and decreased ghrelin,free fatty acides and leptin levels.
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