Hepatobiliary Department, Shengjing Hospital, 36 Sanhao Street, Shenyang, 110004, China.
Obes Surg. 2010 Mar;20(3):375-9. doi: 10.1007/s11695-009-9862-2. Epub 2009 May 27.
Gastric bypass is the most popular technique in obesity therapy. We hypothesize that bypass surgery can help to control the body weight in morbid obesity, and this effect can be enhanced by vagus dissection.
Thirty-six Wistar rats were used in this investigation. They were randomly allocated into six groups. Rats in the gastric bypass group (GB1 and GB2) and the bypass with vagus dissection group (VD1 and VD2) received surgery. Rats in the control group (CO1 and CO2) received sham operation. Twenty days later, rats in the CO1, GB1, and VD1 groups were killed and data on body weights, food intakes, fasting glucose, plasma ghrelin and leptin levels, and GHS-R1a and leptin receptor protein expression in the hypothalamus were collected and summarized. One hundred days later, rats in the CO2, GB2, and VD2 groups were also killed and the same experiments were repeated.
Body weights of rats were 258 +/- 4.2 and 232 +/- 2.4 g in the GB1 and VD1 groups, respectively, much lower than the CO1 group (303 +/- 6.9 g). Body weights of rats were 316 +/- 12.3 and 315 +/- 10.3 g in the GB2 and VD2 groups, respectively, much lower than the CO2 group. Food intake in the VD1 group was lower than in the GB1 group, while there were no statistical differences between the VD2 and GB2 groups. Fasting glucose in the GB1 and GB2 groups was much lower than the CO1 and CO2 groups. Plasma ghrelin concentrations were much lower in the GB1 and VD1 groups compared to the CO1 group. One hundred days after surgery, the ghrelin concentrations in the GB2 and VD2 groups were also much lower than the CO2 group. Leptin concentrations decreased significantly with weight loss after bypass surgery. GHS-R1a protein expression in the hypothalamus was much lower in the GB1 and VD1 groups compared to the CO1 group. GHS-R1a protein expressions in the GB2 and VD2 groups were lower than the CO2 group. There were no statistical differences in leptin receptor expression in the hypothalamus (not shown).
Vagus nerve dissection is effective on body weight control in the early stage, but not in the long term. The hypothalamus is important in weight control by modulating ghrelin and leptin expressions. Bypass surgery can modulate the expression of ghrelin and its receptor. Leptin is also modulated by bypass surgery.
胃旁路术是肥胖症治疗中最常用的技术。我们假设旁路手术可以帮助控制病态肥胖患者的体重,并且这种效果可以通过迷走神经切断术增强。
本研究使用了 36 只 Wistar 大鼠。它们被随机分配到 6 组。接受胃旁路手术的大鼠(GB1 和 GB2)和接受迷走神经切断术的旁路手术大鼠(VD1 和 VD2)接受了手术。对照组(CO1 和 CO2)的大鼠接受了假手术。20 天后,处死 CO1、GB1 和 VD1 组的大鼠,并收集和总结体重、食物摄入量、空腹血糖、血浆胃饥饿素和瘦素水平以及下丘脑 GHS-R1a 和瘦素受体蛋白表达的数据。100 天后,处死 CO2、GB2 和 VD2 组的大鼠,并重复相同的实验。
GB1 和 VD1 组大鼠的体重分别为 258±4.2 和 232±2.4g,明显低于 CO1 组(303±6.9g)。GB2 和 VD2 组大鼠的体重分别为 316±12.3 和 315±10.3g,明显低于 CO2 组。VD1 组大鼠的食物摄入量低于 GB1 组,而 VD2 组与 GB2 组之间无统计学差异。GB1 和 GB2 组大鼠的空腹血糖明显低于 CO1 和 CO2 组。GB1 和 VD1 组大鼠的血浆胃饥饿素浓度明显低于 CO1 组。术后 100 天,GB2 和 VD2 组大鼠的胃饥饿素浓度也明显低于 CO2 组。旁路手术后,随着体重减轻,瘦素浓度显著下降。GB1 和 VD1 组大鼠下丘脑 GHS-R1a 蛋白表达明显低于 CO1 组。GB2 和 VD2 组大鼠下丘脑 GHS-R1a 蛋白表达低于 CO2 组。下丘脑瘦素受体表达无统计学差异(未显示)。
迷走神经切断术在早期对体重控制有效,但在长期内无效。下丘脑在调节胃饥饿素和瘦素表达方面起着重要作用。旁路手术可以调节胃饥饿素及其受体的表达。旁路手术也调节瘦素。