Roux-en-Y胃旁路术对2型糖尿病大鼠肾脏糖异生的影响  

Effect of Roux-en-Y gastric bypass surgery on renal gluconeogenesis in type 2 diabetes mellitus rats

作　　者：文艺[1] 冯犁[2] 张少华[2] 陈振宇[2] 闫洪涛[2] 陈涛[2] 汤礼军[2] 

机构地区：[1]第三军医大学研究生管理大队,重庆400038 [2]成都军区总医院全军普通外科中心,四川成都610083

出　　处：《基础医学与临床》2014年第5期661-666,共6页Basic and Clinical Medicine

基　　金：全军临床高新技术重大项目(2010gxjs040)

摘　　要：目的研究胃旁路术对2型糖尿病大鼠肾脏糖异生的影响,探讨其可能的降糖机制。方法建立2型糖尿病大鼠模型,将大鼠随机分为:对照组,糖尿病模型组,假手术组和手术组。分别于术前及术后4周检测各组大鼠总胆固醇(TC)、三酰甘油(TG)和游离脂肪酸(FAA);术前及术后1、2和4周,检测各组大鼠空腹胰岛素,行口服糖耐量实验(OGTT),计算血糖浓度-时间曲线下面积(AUC)和胰岛素敏感指数(ISI)。术后4周,采用实时荧光定量聚合酶链反应(RT-PCR)和Western blot杂交技术检测肾脏组织中糖异生关键酶:葡萄糖6磷酸酶(G-6-P)和磷酸烯醇式丙酮酸激酶(PEPCK)的mRNA表达及蛋白含量。结果术后4周,手术组大鼠较糖尿病模型和假手术组血脂相关指标降低(P<0.05),空腹血糖及OGTT 2 h血糖值明显下降(P<0.05),AUC明显减小(P<0.05),ISI明显升高(P<0.05),手术组G-6-P和PEPCK mRNA的表达及蛋白含量较糖尿病模型组和假手术组均有降低(P<0.05)。结论胃旁路术能显著降低糖尿病大鼠血糖,改善异常的糖耐量,其降糖机制可能与肾脏糖异生关键酶表达降低,肾脏糖异生减弱有关。Objective To investigate the effect of Roux-en-Y gastric bypass surgery on renal gluconeogenesis in type 2 diabetes mellitus rats,and explore its possible hypoglycemic mechanism.Methods To build diabetes mellitus animal models.Diabetic rats were divided into four groups randomly：control group,diabetes model group （DM group）,sham Roux-en-Y gastric bypass group （SRYGB group）,Roux-en-Y gastric bypass group （RYGB group）.Plasma TG,TC and FFA were measured respectively before and 4th week after the operation in each group rats ; the fasting insulin was measured and OGTT was taken before and 1st,2nd and 4th week after the operation,calculate the AUC of blood glucose concentration-time and ISI.The key enzymes of renal gluconeogenesis：G-6-P and PEPCK were detected using RT-PCR and Western blot respectively 4th week after the operation in each group rats.Results 4 weeks after surgery,RYGB group rats were compared with DM and SRYGB group rats,Roux-en-Y gastric bypass surgery can reduce the level of blood lipid （P ＜ 0.05） and decrease the fasting blood glucose of as well as 2 h after OGTT significantly （P ＜ 0.05）,reduce the AUC （P ＜ 0.05）,increase insulin sensitivity （P ＜ 0.05）,decrease expression of G-6-P and PEPCK mRNA and protein in some degree.Conclusions Roux-en-Y gastric bypass surgery can reduce blood glucose in diabetic rats significantly and improve the glucose tolerance,its mechanism may be related to decrease of G-6-P and PEPCK mRNA and protein levels in renal tissue,weaken renal gluconeogenesis.

关 键 词：胃旁路术 ROUX-EN-Y 糖尿病 肾脏 糖异生 

分 类 号：R656.6[医药卫生—外科学] R587.1[医药卫生—临床医学]