Roux-en-Y胃旁路术对2型糖尿病大鼠炎症因子及脂肪组织胰岛素受体底物-1/2表达影响的实验研究  

Effect of Roux-en-Y Gastric Bypass on Expression of Inflammatory Factors and Insulin Receptor Substrate-1/2 in Adipose Tissue of Type 2 Diabetes Mellitus Rats

作　　者：张立海[1] 夏宾[1] 王娇[1] 黄文丽[1] 王跃生[1] 刘春宇[1] 谭柏宏 尹彦斌[1] 赵冰冰[1] 

机构地区：[1]佳木斯大学附属第一医院普外一科,黑龙江佳木斯154003

出　　处：《中国普外基础与临床杂志》2015年第12期1460-1465,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：2015年佳木斯大学科学技术校级面上项目(编号:13Z1201540);黑龙江省自然科学基金面上项目(编号:D201127);佳木斯大学研究生创新基金项目(编号:LM2015_034);佳木斯大学研究生创新基金项目(编号:LM2015_030)~~

摘　　要：目的研究Roux-en-Y胃转流术(RYGB)对2型糖尿病(T2DM)大鼠血清炎症因子及内脏(附睾)脂肪组织胰岛素受体底物(IRS)-1和IRS-2蛋白表达量的影响,并探讨RYGB治疗T2DM的可能机制。方法将40只SD大鼠建成T2DM模型后,按干预方式将其分为T2MD-RYGB组(n=14)、T2MD-假手术组(n=10)、T2MD组(n=10),另取正常喂养大鼠为对照组(n=10)。T2MD-RYGB组及T2MD-假手术组大鼠分别行RYGB及胃十二指肠离断原位吻合术干预。于术前及术后第1、4、8周(未行手术干预的大鼠与手术大鼠同步检测)检测各组大鼠的空腹血糖(FPG)、空腹血清胰岛素(FINS)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、游离脂肪酸(FFA)水平及计算稳态模型胰岛素抵抗(HOMA-IR)和脂肪组织胰岛素抵抗(Adipo-IR)指数,术后第8周时获取大鼠附睾脂肪组织,测定其IRS-1、IRS-2蛋白表达量。结果术前,T2MD-RYGB组、T2MD-假手术组、T2MD组糖尿病大鼠FPG、FINS、TNF-α、CRP、FFA水平及HOMA-IR、Adipo-IR指数均明显高于对照组(P<0.05)。术后第4周和第8周时,T2MD-RYGB组以上各项指标(除外第4周时FINS值)与术前比较均有所下降,但高于对照组水平(P<0.05);其余各组术后不同时相与术前相比,差异无统计学意义(P>0.05)。T2MD-RYGB组大鼠附睾脂肪组织中IRS-1和IRS-2蛋白表达量较T2MD-假手术组、T2MD组明显增加(P<0.05),但明显低于对照组(P<0.05)。结论RYGB通过上调脂肪组织中IRS-1和IRS-2蛋白表达水平,使其胰岛素敏感性增强,从而降低血清炎症因子水平,最终改善机体胰岛素抵抗,是该术式治疗T2DM的可能机制。Objective To study effect of expression levels of serum inflammatory factors and insulin receptor substrate （IRS）-I/2 in visceral adipose tissue after Roux-en-Y gastric bypass （RYGB） on type 2 diabetes mellitus （T2DM） rats, and explore possible mechanism in treatment of T2DM. Methods The T2DM rats models were established, which were divided into 3 groups by intervention： T2MD-RYGB group （n=14）, T2MD-sham operation （T2MD-SO） group （n=10）, and T2MD group （n=10）, and 10 normal rats were selected as control group. The rats of the T2MD-RYGB group were received the RYGB, and of the T2MD-SO group were received transection and reanastomosis of the gastroin- testinal tract. The fasting plasma glucose （FPG）, fasting insulin （FINS）, C-reaction protein （CRP）, tumor necrosis factor-ct （TNF-a）, free fatty acid （FFA）, homestasis model assessment for insulin resistance （HOMA-IR）, adipose tissue insulin resistance （Adipo-IR） were tested respectively before operation and on week 1, 4, 8 after operation （synchronous detec- tion of rats with or without surgical intervention）. The IRS-1 and IRS-2 protein contents of the rat epididymal adipose tissue were tested on week 8 after operation. Results The FPG, FINS, CRP, TNF-a, FFA levels, and HOMA-IR, Adipo-IR indexes in the T2DM rats were significantly higher thart those in the normal rats （P〈0.05） before operation, the above indicators on week 4, 8 after operation were significantly lower than those before operation in the T2MD-RYGB group （P〈0.05）. The differences of changes among the other groups were not statistically significant （P〉0.05）. The IRS-1 and IRS-2 protein expressions in the adipose tissue of the rats were significantly increased in the T2MD-RYGB group as compared with these indicators in the T2MD group and T2MD-SO group （P〈0.05）, but which were significantly lower than those in the control group （P〈0.05）. Conclusions RYGB could increase IRS-1/2 expression levels in adipose tissue, w

关 键 词：ROUX-EN-Y胃转流术 2型糖尿病 脂肪组织 胰岛素抵抗 胰岛素受体底物 

分 类 号：R587.1[医药卫生—内分泌] R656.6[医药卫生—内科学]