胃袖带切除术对GK大鼠2型糖尿病的影响及其机理  

Effect and Mechanism of Sleeve Gastrectomy for Type 2 Diabetes Mellitus in GK Rats

作　　者：张仕运[1] 孙学军[1] 郑见宝[1] 王炜[1] 刘栋[1] 陈南征[1] 贺赛[1] 周培华[1] 王孝珑 

机构地区：[1]西安交通大学医学院第一附属医院普外科,陕西西安710061

出　　处：《中国普外基础与临床杂志》2013年第12期1363-1368,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：陕西省科学技术研究发展计划项目(项目编号:2011K14-06-01)~~

摘　　要：目的研究胃袖带切除术(sleeve gastrectomy,SG)对GK大鼠2型糖尿病(type 2 diabetes mellitus,T2DM)的治疗作用及其可能机理。方法将13只12周龄的GK大鼠随机分为2组:SG组7只和假手术组(SO组)6只,分别行SG术和假手术。于术前及术后1、4、10和26周测量2组大鼠的体质量、24 h进食量、空腹血糖值、血清胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)和血清生长激素释放肽(Ghrelin)浓度;于术后10周检测2组大鼠的粪便能量含量,并进行口服葡萄糖耐量实验(OGTT)和胰岛素耐受性实验(ITT)。结果①体质量:各时点2组大鼠的体质量比较差异均无统计学意义(P>0.05);与术前比较,术后1周2组大鼠的体质量均降低(P<0.01),术后10和26周的体质量均增加(P<0.01)。②24 h进食量:与SO组比较,术后4和10周SG组大鼠的24 h进食量均较低(P<0.05)。与术前比较,SG组大鼠术后1、4及10周的进食量均较低(P<0.05),SO组大鼠术后1周的进食量低于术前(P<0.05)。③空腹血糖值:与SO组比较,术后各时点SG组大鼠的空腹血糖值均较低(P<0.01)。与术前比较,SG组大鼠术后各时点的空腹血糖值均较低(P<0.01),而SO组大鼠仅术后1周明显低于术前(P<0.01)。④血清GLP-1水平:与SO组比较,术后4、10及26周SG组大鼠的血清GLP-1水平均较高(P<0.05)。与术前比较,术后4、10及26周SG组大鼠的血清GLP-1水平较高(P<0.05),而术后SO组大鼠的血清GLP-1水平无明显变化(P>0.05)。⑤血清Ghrelin水平:与SO组比较,术后各时点SG组大鼠的血清Ghrelin水平均较低(P<0.01)。与术前比较,术后各时点SG组大鼠的血清Ghrelin水平均较低(P<0.001),而SO组大鼠的血清Ghrelin水平无明显变化(P>0.05)。⑥曲线下面积(AUC):SG组大鼠的AUC(OGTT和ITT)均较SO组低(P<0.01)。结论 SG术可以明显降低GK大鼠的空腹血糖值,改善葡萄糖耐量及增强胰岛素敏感性,该作用可能是GLP-1、Grelin等多种胃肠道激素共同作用的结果。SG术可能是潜�Objective To explore the effect and mechanism of sleeve gastrectomy （SG） for type 2 diabetes mellitus （T2DM） in Goto-Kakizaki （GK） rats. Methods Thirteen male GK rats at 12 weeks of age were randomly divided into SG group （n=7） and sham operation group （SO group, n=6）, receiving SG surgery and sham operation respectively. Body weight, food intake in 24 hours, fasting plasma glucose, plasma glucagon-like peptide-1 （GLP-1）, and plasma Ghrelin of rats in 2 groups were measured or tested before operation, 1, 4, 10, and 26 weeks after operation. In 10 weeks after operation, fecal energy content of rats in 2 groups was tested, in addition, oral glucose tolerance test （OGTT） and insulin tolerance test （ITT） were performed to investigate the glucose tolerance and insulin sensitivity. Results @ Body weight： there were no significant difference on body weight between the 2 groups （P〉 0. 05）. Compared with time point of before operation, the body weight of both 2 groups decreased in 1 week after operation （P〈 0. 01）, but increased in 10 weeks and 26 weeks （P〈 0.01）. @ Food intake in 24 hours： compared with SO group, the food intake of SG group were lower in 4 weeks and 10 weeks after operation （P 〈 0.05）. Compared with time point of before operation, the food intake of SG group were lower in 1, 4, and 10 weeks after operation （P〈0. 05）, but lower only in 1 week in SO group （P 〈 0.05）. @ Value of fasting glucose ： compared with SO group, the value of fasting glucose in SG group were lower after operation （P 〈 0.01）. Compared with time point of before operation, the value of fasting glucose of SG group were lower after operation （P〈 0.01）, but decreased in 1 week only in SO group （P〈 0. 01）. @ Level of serum GLP-1 ： compared with SO group, the levels of serum GLP-1 in SG group were higher in 4, 10, and 26 weeks after operation （P〈0.05）. Compared with time point of before operation, the levels of serum GLP-1 in SG group were hig

关 键 词：胃袖带切除术 2型糖尿病 胃肠道激素 大鼠 

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