Diabetes Research Division, Department of Internal Medicine F, Gentofte Hospital, University of Copenhagen, Niels Andersens Vej 65, Hellerup, Denmark.
Diabetes Obes Metab. 2012 Apr;14(4):291-8. doi: 10.1111/j.1463-1326.2011.01505.x. Epub 2011 Nov 13.
Weight-reducing surgical procedures such as Roux-en-Y gastric bypass (RYGB) have proven efficient as means of decreasing excess body weight. Furthermore, some studies report that up to 80% of patients with type 2 diabetes mellitus (T2DM) undergoing RYGB experience complete remission of their T2DM. Interestingly, the majority of remissions occur almost immediately following the operation and long before significant weight loss has taken place. Following RYGB, dramatic increases in postprandial plasma concentrations of the incretin hormone glucagon-like peptide-1 (GLP-1) have been recorded, and the known antidiabetic effects of GLP-1 are thought to be key mediators in RYGB-induced remission of T2DM. However, the published studies on the impact of RYGB on GLP-1 secretion are few, small and often not controlled properly. Furthermore, mechanistic studies delineating the role of endogenous GLP-1 secretion in RYGB-induced remission of T2DM are lacking. This article critically evaluates the current evidence for a role of GLP-1 in RYGB-induced remission of T2DM.
减重手术，如 Roux-en-Y 胃旁路术（RYGB），已被证明是减少超重的有效方法。此外，一些研究报告称，接受 RYGB 的 2 型糖尿病（T2DM）患者中高达 80%的患者经历了 T2DM 的完全缓解。有趣的是，大多数缓解几乎是在手术后立即发生的，而且早在显著减肥之前就发生了。RYGB 后，餐后血浆中肠促胰岛素激素胰高血糖素样肽-1（GLP-1）的浓度显著升高，而 GLP-1 的已知抗糖尿病作用被认为是 RYGB 诱导 T2DM 缓解的关键介质。然而，关于 RYGB 对 GLP-1 分泌影响的已发表研究很少，规模较小，且常常未得到适当控制。此外，阐明内源性 GLP-1 分泌在 RYGB 诱导 T2DM 缓解中的作用的机制研究也很缺乏。本文批判性地评估了 GLP-1 在 RYGB 诱导 T2DM 缓解中的作用的现有证据。
