Washington University School of Medicine in St. Louis, St. Louis, Missouri 63110, USA.
Curr Opin Clin Nutr Metab Care. 2011 Jul;14(4):396-401. doi: 10.1097/MCO.0b013e3283468e50.
PURPOSE OF REVIEW: To review the basic mechanisms of caloric intake reduction of bariatric surgery and its clinical and metabolic outcomes. To describe novel bariatric procedures, their effects on glucose homeostasis and insulin sensitivity and to explain the proposed mechanisms for type 2 diabetes mellitus (T2DM) resolution. RECENT FINDINGS: The effects of surgically induced weight loss on T2DM have elucidated in part the role of proximal and distal gastrointestinal bypass on insulin sensitivity. A dual mechanism for improvement in glucose homeostasis after bariatric surgery has been proposed that appears to be weight loss independent. SUMMARY: Bariatric surgery is the most effective therapy for obesity and obesity-related comorbidities today that provide high rates of resolution of T2DM with improvements in insulin resistance and β-cell function. Novel bariatric procedures offer a unique opportunity to understand the pathophysiology of T2DM and to identify potential pharmacologic targets for effective T2DM treatments and a potential cure.
目的综述：回顾减重手术减少热量摄入的基本机制及其临床和代谢结果。描述新的减重手术，及其对葡萄糖稳态和胰岛素敏感性的影响，并解释 2 型糖尿病（T2DM）缓解的拟议机制。
最近的发现：手术引起的体重减轻对 T2DM 的影响部分阐明了近端和远端胃肠旁路对胰岛素敏感性的作用。提出了一种新的观点，认为减重手术后葡萄糖稳态的改善存在双重机制，且似乎与体重减轻无关。
总结：减重手术是目前治疗肥胖和肥胖相关并发症最有效的方法，它能提高 T2DM 的缓解率，改善胰岛素抵抗和β细胞功能。新型减重手术为理解 T2DM 的病理生理学提供了独特的机会，并为有效的 T2DM 治疗和潜在的治愈方法确定了潜在的药物靶点。
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