Pacheco David, de Luis Daniel Antonio, Romero Alejandro, González Sagrado Manuel, Conde Rosa, Izaola Olatz, Aller Rocío, Delgado Alberto
Unit of Investigation, Hospital Rio Hortega, University of Valladolid, C/Los perales 16, Simancas 47310, Valladolid, Spain.
Am J Surg. 2007 Aug;194(2):221-4. doi: 10.1016/j.amjsurg.2006.11.015.
The antidiabetic effect of bariatric surgery has been interpreted as a conceivable result of surgically induced weight loss and decreased caloric intake. However, glycemic control often occurs within days, before significant weight loss has been reached. The aim of our work was to investigate the hormones that control glycemic status in diabetes mellitus after a duodenal-jejunal exclusion in an animal model of nonobese type 2 diabetes.
Twelve (12- to 14-week-old) rats (Goto-Kakizaki) randomly underwent one of the following procedures: gastrojejunal bypass (group 1, n = 6) or no intervention (controls) (group 2, n = 6). Both groups were fed with the same type and amount of diet. At basal time (preoperative) and after intervention (1 week and 1 month), weight and fasting glycemia were measured. An oral glucose tolerance test (OGTT) was realized at same times. Hormone levels (insulin, glucagons-like peptide 1 [GLP-1], glucose-dependent insulinotropic peptide [GIP], glucagon, and leptin) were measured after 20 minutes of oral glucose overload. Age-matched Goto-Kakizaki rats were used as controls for all variables.
Rats in group 1 and group 2 remained with the same weight during the protocol. The OGTT showed an improvement in glycemic levels in group 1; glucose levels were better at 1 week and 1 month after the surgery in all times of OGTT (basal, 10 minutes, and 120 minutes). Basal glucose levels at time 0 in basal time, at 1 week, and at 1 month were lower in group 1 than group 2. Postoral glucose overload levels of glucagon, insulin, GLP-1, and GIP remained unchanged during the treatment in both groups. In group 1, leptin levels had a significant decrease at 1 week and 1 month after surgery (basal time (6.1 +/- 1.6 ng/mL) versus 1 week (0.9 +/- 0.9 ng/mL) versus 1 month (0.7 +/- 0.6 ng/mL) (P < .05).
Gastrojejunal bypass in a nonobese diabetic model improves glycemic control with a significant decrease in leptin levels, without changes in enteroinsular axis (GLP-1, GIP, glucagons, and insulin levels).
减肥手术的抗糖尿病作用被认为是手术引起体重减轻和热量摄入减少的必然结果。然而，血糖控制通常在数天内就会出现，此时体重尚未显著下降。我们研究的目的是在非肥胖型2型糖尿病动物模型中，探究十二指肠空肠转位术后控制糖尿病血糖状态的激素。
12只（12至14周龄）大鼠（Goto-Kakizaki）随机接受以下手术之一：胃空肠旁路术（第1组，n = 6）或不进行干预（对照组）（第2组，n = 6）。两组喂食相同类型和数量的食物。在基础时间（术前）以及干预后（1周和1个月），测量体重和空腹血糖。同时进行口服葡萄糖耐量试验（OGTT）。口服葡萄糖负荷20分钟后，测量激素水平（胰岛素、胰高血糖素样肽1 [GLP-1]、葡萄糖依赖性促胰岛素多肽 [GIP]、胰高血糖素和瘦素）。所有变量均使用年龄匹配的Goto-Kakizaki大鼠作为对照。
在实验过程中，第1组和第2组大鼠体重保持不变。OGTT显示第1组血糖水平有所改善；在OGTT的所有时间点（基础、10分钟和120分钟），术后1周和1个月时的血糖水平均更佳。第1组在基础时间0、1周和1个月时的基础血糖水平低于第2组。两组治疗期间，口服葡萄糖负荷后胰高血糖素、胰岛素、GLP-1和GIP水平均保持不变。在第1组中，术后1周和1个月时瘦素水平显著降低（基础时间（6.1±1.6 ng/mL）对比术后1周（0.9±0.9 ng/mL）对比术后1个月（0.7±0.6 ng/mL）（P <.05）。
在非肥胖糖尿病模型中，胃空肠旁路术可改善血糖控制，同时瘦素水平显著降低，而肠胰岛轴（GLP-1、GIP、胰高血糖素和胰岛素水平）无变化。
