CAJ | 학술논문

目的：通过研究脂联素及胰岛凋亡相关蛋白的变化，探讨Roux-en-Y胃旁路术（RYGB ）减少胰岛细胞凋亡的机制。方法60只SD大鼠随机分为RYGB组、2型糖尿病（T2DM）组和正常对照（NC）组，每组20只。NC组喂食正常饲料；为了建立T2DM动物模型，T2DM组和RYGB组大鼠喂食高脂饮食（22.19 kJ/g）3周，并于第13天经腹腔注入链脲佐菌素（STZ，30 mg/kg）。造模成功后，RYGB组大鼠行RYGB手术、T2DM及NC组行假手术。术前、术后7、14及21 d测定体质量；术前及术后21 d测定空腹血糖，ELISA法测定血浆脂联素水平；术后21 d免疫组化SABC法检测胰岛Bcl-2、Caspase 8、Caspase 9表达。结果术前3组体质量差异无统计学意义；RYGB和T2DM组血糖明显高于NC组，脂联素水平明显低于NC组（P<0.05）。与T2DM及NC组相比，术后RYGB组体质量明显降低。与T2DM组相比RYGB组术后21 d时血糖明显降低、脂联素水平明显升高（P<0.05），RYGB组与NC组相比差异无统计学意义。与T2DM组相比RYGB组术后胰岛Bcl-2表达明显升高，Caspase 8、Caspase 9表达明显降低（P<0.05）。结论 RYGB术后可以使脂联素水平升高、Bcl-2表达增加，Caspase 8、Caspase9表达减少；RYGB术可能通过线粒体通路减少胰岛细胞凋亡。
목적：통과연구지련소급이도조망상관단백적변화，탐토Roux-en-Y위방로술（RYGB ）감소이도세포조망적궤제。방법60지SD대서수궤분위RYGB조、2형당뇨병（T2DM）조화정상대조（NC）조，매조20지。NC조위식정상사료；위료건립T2DM동물모형，T2DM조화RYGB조대서위식고지음식（22.19 kJ/g）3주，병우제13천경복강주입련뇨좌균소（STZ，30 mg/kg）。조모성공후，RYGB조대서행RYGB수술、T2DM급NC조행가수술。술전、술후7、14급21 d측정체질량；술전급술후21 d측정공복혈당，ELISA법측정혈장지련소수평；술후21 d면역조화SABC법검측이도Bcl-2、Caspase 8、Caspase 9표체。결과술전3조체질량차이무통계학의의；RYGB화T2DM조혈당명현고우NC조，지련소수평명현저우NC조（P<0.05）。여T2DM급NC조상비，술후RYGB조체질량명현강저。여T2DM조상비RYGB조술후21 d시혈당명현강저、지련소수평명현승고（P<0.05），RYGB조여NC조상비차이무통계학의의。여T2DM조상비RYGB조술후이도Bcl-2표체명현승고，Caspase 8、Caspase 9표체명현강저（P<0.05）。결론 RYGB술후가이사지련소수평승고、Bcl-2표체증가，Caspase 8、Caspase9표체감소；RYGB술가능통과선립체통로감소이도세포조망。
Objective To explore the anti-apoptotic mechanism of Roux-en-Y gastric bypass (RYGB) through exam?ine the postoperative change of adiponectin levels and expressions of pancreatic islets relative apoptotic protein. Methods Sixty SD rats were randomly allocated to RYGB group (n=20), type 2 diabetes mellitus group (T2DM, n=20) and normal con?trol group (NC, n=20). Rats in the NC group were fed with normal diet. In order to make type 2 diabetic rat models, the rats in the T2DM and RYGB groups were fed with high fat diet (22.19 kJ/g) combined with administration of intraperitoneal strep?tozotocin injection (STZ, 30 mg/kg) on the 13th day of high fat diet. RYGB operation were performed in RYGB group and sham-operation were performed in the T2DM and NC groups when diabetic model was contructed. Rats were weight preoper?atively and at the 7th, 14th, 21st days after operations. Fasting plasma glucose and adiponectin (ELISA) were measured preoper?atively and at 21st day postoperatively. Protein expressions of Bcl-2,Caspase 8 and Caspase 9 in pancreatic islets were ex?amined by immunohistochemistry at the 21st day postoperatively. Results Body weights do not vary significantly among three groups preoperatively. Compared to rats in the NC group, fast plasma glucose level was higher but adiponectin was low?er in rats in RYGB and T2DM groups. Body weights of rats in RYGB group decreased significantly compared to those of rats in NC and T2DM groups postoperatively. Compared to rats in T2DM group, fasting glucose level was lower while adiponectin concentrations was higher in rats in RYGB group but no differences of these parameters were seen in rats in NC group at the 21st day postoperatively. Expression of Bcl-2 in RYGB group was significantly elevated while expressions of Caspase 8 and Caspase 9 were significantly decreased compared to those in T2DM group postoperatively. Conclusion Adiponectin levelswas elevated;expressions of Bcl-2 was increased;expressions of Caspase 8, Caspase 9 were decreased upon RYGB opera?tion in T2DM model. RYGB might reduce pancreatic islets apoptosis through mitochondrial pathway.