Quercia I, Dutia R, Kotler D P, Belsley S, Laferrère B
New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, 1111, Amsterdam Avenue, 1034 New York, NY 10025, USA; Department of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
Division of Gastroenterology and Liver Disease, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA; Department of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA; Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
Diabetes Metab. 2014 Apr;40(2):87-94. doi: 10.1016/j.diabet.2013.11.003. Epub 2013 Dec 17.
Severe obesity is a preeminent health care problem that impacts overall health and survival. The most effective treatment for severe obesity is bariatric surgery, an intervention that not only maintains long-term weight loss but also is associated with improvement or remission of several comorbidies including type 2 diabetes mellitus. Some weight loss surgeries modify the gastrointestinal anatomy and physiology, including the secretions and actions of gut peptides. This review describes how bariatric surgery alters the patterns of gastrointestinal motility, nutrient digestion and absorption, gut peptide release, bile acids and the gut microflora, and how these changes alter energy homeostasis and glucose metabolism.
重度肥胖是一个突出的医疗保健问题,会影响整体健康和生存。治疗重度肥胖最有效的方法是减肥手术,这种干预措施不仅能维持长期体重减轻,还与包括2型糖尿病在内的几种合并症的改善或缓解有关。一些减肥手术会改变胃肠道的解剖结构和生理功能,包括肠道肽的分泌和作用。这篇综述描述了减肥手术如何改变胃肠动力、营养物质消化和吸收、肠道肽释放、胆汁酸和肠道微生物群的模式,以及这些变化如何改变能量稳态和葡萄糖代谢。