Handa Rajash K, Evan Andrew P, Connors Bret A, Johnson Cynthia D, Liu Ziyue, Alloosh Mouhamad, Sturek Michael, Evans-Molina Carmella, Mandeville Jessica A, Gnessin Ehud, Lingeman James E
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
J Urol. 2014 Oct;192(4):1257-65. doi: 10.1016/j.juro.2014.03.035. Epub 2014 Mar 18.
We determined whether shock wave lithotripsy of the kidney of pigs with metabolic syndrome would worsen glucose tolerance or increase the risk of diabetes mellitus.
Nine-month-old female Ossabaw miniature pigs were fed a hypercaloric atherogenic diet to induce metabolic syndrome. At age 15 months the pigs were treated with 2,000 or 4,000 shock waves (24 kV at 120 shock waves per minute) using an unmodified HM3 lithotripter (Dornier MedTech, Kennesaw, Georgia). Shock waves were targeted to the left kidney upper pole calyx to model treatment that would also expose the pancreatic tail to shock waves. The intravenous glucose tolerance test was done in conscious fasting pigs before lithotripsy, and 1 and 2 months after lithotripsy with blood samples taken for glucose and insulin measurement.
Pigs fed the hypercaloric atherogenic diet were obese, dyslipidemic, insulin resistant and glucose intolerant, consistent with metabolic syndrome. Assessments of insulin resistance, glucose tolerance and pancreatic β cell function from fasting plasma glucose and insulin levels, and the glucose and insulin response profile to the intravenous glucose tolerance test were similar before and after lithotripsy.
The metabolic syndrome status of pigs treated with shock wave lithotripsy was unchanged 2 months after kidney treatment with 2,000 high amplitude shock waves or overtreatment with 4,000 high amplitude shock waves. These findings do not support a single shock wave lithotripsy treatment of the kidney as a risk factor for the onset of diabetes mellitus.
我们确定对患有代谢综合征的猪的肾脏进行冲击波碎石术是否会恶化糖耐量或增加患糖尿病的风险。
给9月龄雌性奥萨巴微型猪喂食高热量致动脉粥样化饮食以诱导代谢综合征。15月龄时，使用未改良的HM3碎石机（多尼尔医疗技术公司，佐治亚州肯尼索）对猪施加2000或4000次冲击波（24 kV，每分钟120次冲击波）。冲击波靶向左肾上极肾盂，以模拟也会使胰尾暴露于冲击波的治疗。在清醒禁食的猪身上于碎石术前、碎石术后1个月和2个月进行静脉葡萄糖耐量试验，并采集血样测量葡萄糖和胰岛素。
喂食高热量致动脉粥样化饮食的猪肥胖、血脂异常、胰岛素抵抗且糖耐量异常，符合代谢综合征表现。根据空腹血糖和胰岛素水平以及静脉葡萄糖耐量试验的葡萄糖和胰岛素反应曲线对胰岛素抵抗、糖耐量和胰腺β细胞功能进行的评估在碎石术前和术后相似。
在用2000次高振幅冲击波进行肾脏治疗或用4000次高振幅冲击波过度治疗后2个月，接受冲击波碎石术的猪的代谢综合征状态未改变。这些发现不支持将单次肾脏冲击波碎石术治疗作为糖尿病发病的危险因素。
