Ileal transposition rapidly improves glucose tolerance and gradually improves insulin resistance in non-obese type 2 diabetic rats  

空肠间置术能快速改善非肥胖2型糖尿病大鼠的糖耐量并缓慢改善胰岛素抵抗

作　　者：Hengliang Zhu Huaiming Wang Zhihai Zheng Bailiang Ye Xiaojiao Ruan Xiaofeng Zheng Guoxin Li 

机构地区：[1]Department of General Surgery,Nanfang Hospital,Southern Medical University,Guangzhou,Guangdong,China [2]Department of Gastrointestinal Surgery,The Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen,Guangdong,China [3]Department of Colorectal Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,China [4]Department of Gastrointestinal Surgery,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang,China

出　　处：《Gastroenterology Report》2018年第4期291-297,I0002,共8页胃肠病学报道（英文）

摘　　要：Background:Many studies have confirmed that ileal transposition can improve type 2 diabetes mellitus(T2DM),accompanied by increased glucagon-like peptide-1(GLP-1).We performed the experiment on diabetic rats to evaluate the effects and mechanisms of ileal transposition on the glycemic metabolism.Methods:Twenty Goto-Kakizaki(GK)rats were randomly divided into the ileal transposition group(IT group)and the sham operation group(Shamgroup).Weight,food intake,fasting plasma glucose(FPG),fasting insulin(F-ins),oral glucose tolerance test(OGTT)and GLP-1 were determined at baseline and 1,4,8,16 and 24weeks post-operatively.The homeostasis model assessment-insulin resistance(HOMA-IR)index and the area under the curve(AUC)during OGTT were measured.Histological determination of the GLP-1 receptor(GLP-1R)was performed on the pancreas and ileum24weeks post-operatively.Results:In comparison with the Sham group,the IT group showed a higher GLP-1 level and lower AUC at 4,8,16 and 24 weeks post-operatively(all P<0.05)and a lower FPG,F-ins levels and HOMA-IR at 8,16 and 24 weeks post-operatively(all P<0.05).Compared with baseline levels,the plasma GLP-1,AUC and FPG levels decreased significantly at each postoperative time point in the IT group(all P<0.05),but not in the Sham group(all P>0.05);F-ins and HOMA-IR significantly decreased at 8,16 and 24 weeks post-operatively in the IT group(all P<0.05).GLP-1R expression in the IT group was significantly higher than that of the Sham group in both the pancreas and the ileum at 24 weeks post-operatively(P<0.05).Conclusions:Ileal transposition ameliorated glucose metabolism without reduction in weight or food intake in GK rats,which may be induced by the increased GLP-1 expression.However,the delayed improvement of insulin resistance,accompanied by decreased plasma insulin levels,might not directly result from the increased GLP-1.背景:许多研究已证实,回肠间置术能改善2型糖尿病(T2DM),同时胰高血糖素样肽-1(GLP-1)水平上升。我们采用糖尿病大鼠模型进行研究,评估回肠间置术对糖代谢的影响及其机制。方法:20只GK大鼠被随机分为回肠间置组和假手术组。分别于术前及术后1、4、8、16、24周检测大鼠体重、进食量、空腹血糖(FPG)、空腹胰岛素(F-ins)、口服葡萄糖耐量试验(OGTT)和GLP-1水平。计算稳态模型胰岛素抵抗指数(HOMA-IR)和OGTT曲线下面积(AUC)。术后24周处死大鼠,检测胰腺和回肠组织中GLP-1受体(GLP-1R)的表达水平。结果:与假手术组相比,回肠间置组大鼠术后4、8、16和24周血GLP-1水平更高(均P<0.05),术后8、16和24周FPG、F-ins和HOMAIR水平更低(均P<0.05)。与术前相比,回肠间置组术后各个时间点均可观察到血GLP-1、AUC和FPG水平的下降(均P<0.05);术后8、16和24周F-ins和HOMA-IR也显著下降(均P<0.05)。术后24周,无论是胰腺还是回肠组织,回肠间置组大鼠的GLP-1R表达水平均显著高于假手术组(均P<0.05)。结论:回肠间置可改善GK大鼠的糖代谢,且不会导致体重的下降和进食量的减少,这可能与GLP-1水平升高有关。而后期胰岛素抵抗的改善和胰岛素水平的下降可能并不直接受益于GLP-1水平的升高。

关 键 词：Type 2 diabetes mellitus ileal transposition glucagon-like peptide-1 glycemic metabolism 

分 类 号：R58[医药卫生—内分泌]