胃旁路术对“肠-胰岛轴”相关激素及二肽基肽酶-Ⅳ分泌的影响  

Effects of the gastric bypass surgery on secretion of hormone of "enteroinsular axis" and dipeptidyl peptidase-Ⅳ

作　　者：喻敏[1] 于浩[1] 邹忠东[1] 黄盛[1] 王俊杰[1] 王瑜[1] 

机构地区：[1]福建医科大学福总临床医学院普通外科,福建福州350025

出　　处：《中国普通外科杂志》2012年第10期1244-1248,共5页China Journal of General Surgery

基　　金：福建省科技合作重点项目(2012I0007);南京军区医药卫生科研重点专项(09Z031);福建省科技计划重点项目(2009Y0039)

摘　　要：目的:探讨胃旁路术(GBP)在降低2型糖尿病(T2DM)大鼠血糖过程中对"肠-胰岛轴"相关激素及二肽基肽酶IV(DPP-IV)分泌的影响。方法:将24只雄性自发性非肥胖型糖尿病(GK)大鼠随机均分为胃旁路组和假手术组,记录并对比两组大鼠术前及术后1,2,4,8,12,24,48周体质量、空腹血糖及血浆DPP-IV、"肠-胰岛轴"相关激素胰高血糖素样肽1(GLP-1)水平。结果:术前两组大鼠间各项观察指标无明显差异(均P>0.05);两组大鼠体质量均在术后1周内明显降低,但随后逐渐回升,且两组间体质量在术后各时间点均无统计学差异(均P>0.05);与术前比较,假手术组大鼠术后空腹血糖及血浆DPP-IV,GLP-1水平无明显变化,胃旁路组空腹血糖及血浆DPP-IV水平明显降低,而GLP-1水平明显增高(均P<0.01),且两组间空腹血糖及血浆DPP-IV,GLP-1水平在术后各时间点上的差异均有统计学意义(均P<0.01)。结论:胃旁路术控制血糖的作用可能与抑制DPP-IV的活性,使机体中"肠-胰岛轴"上GLP-1水平升高有关。Objective： To investigate the effect of gastric bypass procedure （GBP） on the secretion of the hormone of the ＂enteroinsular axis＂ and dipeptidyl peptidase-IV （DPP-IV） during exertion of its blood sugar-lowering action in rats with type 2 diabetes mellitus （T2DM）. Methods： Twenty-four male spontaneous non-obese diabetic Goto-Kakizaki （GK） rats were equally randomized to undergo either gastric bypass surgery （GBP group） or sham operation （sham operation group）. The body weight, fasting blood glucose, and the levels of DPP-IV and ＂enteroinsular axis＂ hormone glucagons- like peptide 1 （GLP-1） before and 1 week, 2, 4, 8, 12, 24 and 48 weeks after surgery of the two groups were recorded and compared. Results： The recorded parameters between the two groups had no obvious differences before operation （all P〉0.05）. The body weights of rats in both groups decreased significantly within the first week after surgery and then recovered gradually, but at each predefined time point, there were no significant differences between the two groups （all P〉0.05）. Compared with those before surgery, the levels of fasting blood glucose, and plasma DPP-IV and GLP-1 in sham operation group did not change after surgery （all P〈0.01 ）; while the fasting blood sugar and plasma DPP-IV significantly decreased and GLP-1 level significantly increased in GBP group （all P〈0.01）. In addition, the levels of fasting blood glucose, DPP-IV and GLP-1 between the two groups had statistical significance at each observation time point after surgery （all P〈0.01）. Conclusion： The blood sugar control effect of GBP may be associated with its increasing the GLP-1 level of the ＂enteroinsular axis＂ through inhibiting the DPP-IV activity.

关 键 词：糖尿病 2型/外科学 胃旁路术 抗原 CD26 胰高血糖素样肽1 

分 类 号：R656.6[医药卫生—外科学]