Obesity Unit, Endocrinology and Diabetes Department, Hospital Clínic Universitari, Villarroel 170, 08036 Barcelona, Spain.
Curr Atheroscler Rep. 2013 Oct;15(10):357. doi: 10.1007/s11883-013-0357-1.
The parallel occurrence of improved glucose tolerance and increased glucagon-like peptide 1 (GLP-1) response to meal intake following metabolic surgery (MS) demonstrated in several studies has led to the notion that GLP-1 is the culprit for the impressive rates of remission of type 2 diabetes mellitus (T2DM) following MS. In this article, we critically review current evidence supporting this view. Recent studies specifically designed to elucidate a causative role of GLP-1 in the antidiabetic effects of MS call into question GLP-1 as a key player for T2DM outcome following MS procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese subjects. Whether GLP-1 plays a more prominent role in the remission of T2DM following MS in subjects with moderate obesity warrants further studies. Appraisal of the mechanisms involved in the amelioration of hyperglycemia following MS is a priority, as it could help in the battle against the current combined epidemics of obesity and T2DM.
代谢手术后（MS），多项研究均表明，葡萄糖耐量改善和进食后胰高血糖素样肽 1（GLP-1）反应增强同时出现，这使人们认为 GLP-1 是 MS 后 2 型糖尿病（T2DM）缓解率显著提高的罪魁祸首。本文批判性地回顾了支持这一观点的现有证据。最近专门设计的研究旨在阐明 GLP-1 在 MS 的抗糖尿病作用中的因果关系，这使 GLP-1 作为肥胖患者 Roux-en-Y 胃旁路和袖状胃切除术等 MS 手术后 T2DM 结局的关键因素受到质疑。GLP-1 是否在中度肥胖患者的 MS 后 T2DM 缓解中发挥更重要的作用，值得进一步研究。评估 MS 后血糖改善所涉及的机制是当务之急，因为这有助于对抗当前肥胖和 T2DM 的联合流行。
