胃袖状切除对GK大鼠血糖、ghrelin和胰高血糖素样肽-1水平的影响  

Influence of Sleeve Gastrectomy on Blood Glucose,Ghrelin,and Glucagon Like Peptide-1 Levels in GK Rats

作　　者：朱占永[1] 严玲玲[1] 吴丹[1] 罗晓[1] 吴毅平[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院整形外科,湖北武汉430030

出　　处：《中国普外基础与临床杂志》2011年第6期603-609,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：武汉市科技攻关项目(项目编号:201060938360-07);华中科技大学研究生创新基金项目(项目编号:HF-06-026-08-540)~~

摘　　要：目的探讨胃袖状切除术的降糖作用及其作用机理。方法按照随机数字表达法将非肥胖的2型糖尿病大鼠（GK大鼠）分为袖状胃切除组（SG组）、假手术组（SO组）、饮食配对组（PF组）和空白对照组（BC组）。动态观察术前和术后24周内各组大鼠体重、空腹血糖、葡萄糖耐量（口服葡萄糖耐量试验,OGTT）、胰岛素耐量（胰岛素耐量试验,ITT）及胰岛素、生长激素释放肽ghrelin和胰高血糖素样肽-1（GLP-1）水平的变化。结果自术后4周起SG组和PF组的体重增量开始明显小于SO组（P〈0.01）。自术后2周起SG组的空腹血糖水平较其他3组明显降低（P〈0.05）。自术后2周起SG组对葡萄糖的耐量较术前和其他3组相应时相明显改善（P〈0.01）。术后第6周SG组对胰岛素的敏感性较SO组明显改善（P〈0.05,P〈0.01）。术后2~24周SG组与SO组比较,胰岛素水平的差异均无统计学意义（P〉0.05）,ghrelin水平明显下降（P〈0.01）,GLP-1水平明显升高（P〈0.01）。结论胃袖状切除术的降糖效果确切,能够独立于体重的变化而直接有效地降低血糖;术后ghrelin水平下降及GLP-1水平升高可能是胃袖状切除降糖的主要机理。Objective To investigate the effect and mechanism of sleeve gastrectomy（SG） on reducing blood glucose level.Methods Thirty GK rats were randomly divided into SG group,sham operation（SO） group,pair-fed（PF） group,and blank control（BC） group.The changes of weight,fasting blood glucose,glucose tolerance（oral glucose tolerance test,OGTT）,insulin tolerance（insulin tolerance test,ITT）,plasma insulin,ghrelin,and glucagon like peptide-1（GLP-1） were monitored before and 24 weeks after operation respectively.Results From the 4th week after operation,weight gain in SG group and PF group began to decrease significantly compared with SO group（P0.01）.From the 2nd week after operation,fasting blood glucose level in SG group was lower than that in SO,PF,and BC groups（P0.05）,and the glucose tolerance in SG group obviously improved compared with pre-operation and the other 3 groups（P0.01）.On the 6th week after operation,the insulin sensitivity in SG group obviously improved compared with SO group（P0.05,P0.01）.There was no significant difference of insulin level between SG group and SO group（P0.05）,ghrelin level significantly decreased（P0.01） while GLP-1 level significantly increased（P0.01） in SG group compared with SO group during 2-24 weeks after operation.Conclusions The effect of SG on reducing blood glucose is definite.SG can directly lower blood glucose independent with weight loss.Postoperative decreased ghrelin level and increased GLP-1 level may be its primary mechanism.

关 键 词：胃袖状切除术 Goto-kakizaki大鼠 生长激素释放肽ghrelin 胰高血糖素样肽-1 

分 类 号：R656.61[医药卫生—外科学] R587.1[医药卫生—临床医学]