Czupryniak L, Pawłowski M, Szymański D, Olejniczak W, Saryusz-Wolska M, Loba J, Strzelczyk J
Department of Internal Medicine and Diabetology, Barlicki University Hospital No 1, Medical University of Lodz, Lodz, Poland.
Exp Clin Endocrinol Diabetes. 2011 Mar;119(3):186-9. doi: 10.1055/s-0030-1267201. Epub 2011 Mar 3.
Morbidly obese patients undergoing gastric bypass surgery experience early satiety soon after the surgery; the mechanism of this effect is poorly understood. As blood glucose concentration plays a role in appetite regulation in humans, we hypothesized that after gastric bypass surgery glucose absorbed mainly in jejunum leads to a greater rise in plasma glucose that if it is ingested in stomach.
24 non-diabetes morbidly obese patients (15 women, 9 men, mean age [± SD] 35.6 ± 11.9 years, body weight 140.7 ± 33.1 kg, BMI 46.8 ± 8.3 kg/m²) undergoing Roux-en-Y gastric bypass surgery were given 10 ml of 40% glucose solution to the stomach before its size reduction and to the jejunum after gastro-jejunal anastomosis was formed.
After jejunal infusion blood glucose increased more rapidly and was ∼30% higher than after stomach infusion. Moreover, this increase was less pronounced in more obese patients.
In patients after Roux-en-Y gastric bypass surgery glucose absorbed in jejunum leads to greater rise in plasma glucose concentration than if it is ingested in stomach. This phenomenon may help explain satiety feeling occurring early in gastric bypass surgery patients.
接受胃旁路手术的病态肥胖患者在术后很快就会出现早饱感；这种效应的机制尚不清楚。由于血糖浓度在人类食欲调节中起作用，我们推测胃旁路手术后主要在空肠吸收的葡萄糖会导致血浆葡萄糖的升高幅度大于在胃中摄入时的升高幅度。
对24例接受Roux-en-Y胃旁路手术的非糖尿病病态肥胖患者（15名女性，9名男性，平均年龄[±标准差]35.6±11.9岁，体重140.7±33.1kg，BMI 46.8±8.3kg/m²），在胃缩小前将10ml 40%葡萄糖溶液注入胃内，在胃空肠吻合形成后注入空肠。
空肠输注后血糖升高更快，比胃输注后高约30%。此外，在更肥胖的患者中这种升高不太明显。
在接受Roux-en-Y胃旁路手术的患者中，空肠吸收的葡萄糖比在胃中摄入时导致血浆葡萄糖浓度升高幅度更大。这种现象可能有助于解释胃旁路手术患者早期出现的饱腹感感觉。
