Molecular and Metabolic Imaging Group, Institute of Clinical Sciences, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.
Nat Rev Gastroenterol Hepatol. 2013 Oct;10(10):575-84. doi: 10.1038/nrgastro.2013.119. Epub 2013 Jul 9.
The clinical efficacy of bariatric surgery has encouraged the scientific investigation of the gut as a major endocrine organ. Manipulation of gastrointestinal anatomy through surgery has been shown to profoundly affect the physiological and metabolic processes that control body weight and glycaemia. The most popular bariatric surgical procedures are gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy. Even though these procedures were designed with the aim of causing restriction of food intake and nutrient malabsorption, evidence suggests that their contributions to weight loss are minimal. Instead, these interventions reduce body weight by decreasing hunger, increasing satiation during a meal, changing food preferences and energy expenditure. In this Review, we have explored these mechanisms as well as their mediators. The hope is that that their in-depth investigation will enable the optimization and individualization of surgical techniques, the development of equally effective but safer nonsurgical weight-loss interventions, and even the understanding of the pathophysiology of obesity itself.
减重手术的临床疗效促使人们深入研究肠道作为主要内分泌器官的作用。通过手术对胃肠道解剖结构的干预已被证实可深刻影响控制体重和血糖的生理和代谢过程。目前最流行的减重手术包括胃旁路术、可调胃束带术和垂直袖状胃切除术。尽管这些手术旨在限制食物摄入和营养吸收，但有证据表明，这些手术对体重减轻的贡献微乎其微。相反，这些干预措施通过减少饥饿感、增加进食时的饱腹感、改变食物偏好和能量消耗来减轻体重。在这篇综述中，我们探讨了这些机制及其介导因素。我们希望对这些机制的深入研究将能够优化和个体化手术技术，开发同样有效的但更安全的非手术减重干预措施，甚至有助于理解肥胖症本身的病理生理学。
