Department of General Surgery, China Medical University affiliated Shengjing Hospital, 36 Sanhao Street, Shenyang, 110004, China.
Obes Surg. 2011 Jun;21(6):768-73. doi: 10.1007/s11695-011-0357-6.
The resolution of type 2 diabetes mellitus is an additional outcome of Roux-en-Y gastric bypass (RYGB) surgery. The general objective was to explore whether RYGB could reduce beta cells apoptosis and what roles adiponectin played in downregulating hyperglycemia after RYGB.
Twenty Goto-Kakizaki (GK) rats were allocated in RYGB group (ten) and GK group (ten), and ten Wistar (WS) rats were allocated in WS group. RYGB was performed in RYGB group and sham operation in the GK and WS groups. Fasting plasma glucose, body weight, food intake per 100 g body weight, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), C peptide, and adiponectin were measured pre- and postoperatively. Terminal deoxynucleotidyl transferase 2'-deoxyuridine 5'-triphosphate nick end-labeling and transmission electron microscopy were performed to detect apoptosis of pancreatic beta cells. Data were analyzed by analysis of variance, Student t test, and post hoc comparisons (Tukey's test).
Animals in WS group had significant higher postprandial insulin, C peptide, and adiponectin concentrations compared to RYGB and GK groups preoperatively. Body weight and food intake in RYGB group significantly decreased compared to WS and GK groups postoperatively. Postprandial insulin, C peptide, and adiponectin concentrations significantly increased, while fasting plasma glucose and HOMA-IR values decreased in RYGB group compared to GK group postoperatively. More apoptotic beta cells were detected in GK group than RYGB and WS groups postoperatively.
RYGB could increase postprandial insulin and reduce pancreatic islet apoptosis. Adiponectin played a key role in regulating plasma glucose and reducing pancreatic islet apoptosis after RYGB.
2 型糖尿病的缓解是 Roux-en-Y 胃旁路（RYGB）手术的另一个结果。主要目的是探讨 RYGB 是否可以减少β细胞凋亡，以及脂联素在 RYGB 后下调高血糖方面发挥了什么作用。
将 20 只 Goto-Kakizaki（GK）大鼠分为 RYGB 组（10 只）和 GK 组（10 只），10 只 Wistar（WS）大鼠分为 WS 组。RYGB 组进行 RYGB，GK 组和 WS 组进行假手术。术前和术后测定空腹血糖、体重、每 100g 体重的食物摄入量、胰岛素、稳态模型评估的胰岛素抵抗指数（HOMA-IR）、C 肽和脂联素。末端脱氧核苷酸转移酶 2'-脱氧尿苷 5'-三磷酸末端标记和透射电镜检测胰岛β细胞凋亡。数据采用方差分析、Student t 检验和事后比较（Tukey 检验）进行分析。
WS 组动物术后餐后胰岛素、C 肽和脂联素浓度明显高于 RYGB 组和 GK 组术前。RYGB 组术后体重和食物摄入量明显低于 WS 组和 GK 组。与 GK 组相比，RYGB 组术后餐后胰岛素、C 肽和脂联素浓度明显增加，空腹血糖和 HOMA-IR 值降低。术后 GK 组β细胞凋亡较 RYGB 组和 WS 组明显增加。
RYGB 可增加餐后胰岛素，减少胰岛细胞凋亡。脂联素在 RYGB 后调节血糖和减少胰岛细胞凋亡中起关键作用。
