Marambio Andrés, Watkins Guillermo, Castro Fabiola, Riffo Andrea, Zúñiga Roberta, Jans Jaime, Villanueva María E, Díaz Guillermo
Andrés Marambio, Guillermo Watkins, Andrea Riffo, Jaime Jans, Department of Surgery, University of Chile Clinical Hospital, Santiago 8380456, Chile.
World J Gastroenterol. 2014 Jun 7;20(21):6534-40. doi: 10.3748/wjg.v20.i21.6534.
To describe the variation that divalent metal transporter 1 (DMT1) shows in patients after Roux-en-Y gastric bypass (RYGB) surgery.
Prospective and analytical study of DMT1 level at the brush border of proximal jejunum in patients having undergone RYGB surgery. The mucosa of proximal jejunum forming the gastrojejunal anastomosis was biopsied during surgery and after 6 mo later with an endoscopic biopsy. All the patients received precise instructions regarding feeding and nutritional supplementation. Both samples were processed at the same time by immunohistochemistry and western blot. Samples were analysed by a pathologist. For statistical analysis, the χ(2) and Wilcoxon tests were used.
Sixteen patients were recruited, 13 of whom completed the study. Twelve were women. Average age and body mass index (BMI) were 44.1 and 40.4, respectively. Both body weight and BMI decreased significantly during the study period, with an average percent excess weight loss (%EWL) of 60% ± 13.3% and an average percent excess BMI loss (%EBMIL) of 79.6% ± 21.6%. Only two patients presented with mild anaemia 6 mo after surgery, but their ferritin levels stayed within normal ranges. Staining for DMT1 showed a significant increase in the cytoplasm of enterocytes located at the tips of the villi (χ(2) = 6.03; P = 0.049). Nevertheless, the total quantity of DMT1 decreased significantly (Z = 2.04; P = 0.04). Associated with these results, we observed a significant increase in goblet cells in the villi 6 mo postoperatively (Z = -2.47; P = 0.013).
Six months after RYGB surgery, patients exhibit an increase in DMT1 expression in the enterocytes of the tips of the villi at the proximal jejunum.
描述二价金属离子转运体1（DMT1）在Roux-en-Y胃旁路术（RYGB）患者术后的变化情况。
对接受RYGB手术患者近端空肠刷状缘处DMT1水平进行前瞻性分析研究。在手术过程中以及术后6个月时，通过内镜活检获取形成胃空肠吻合口的近端空肠黏膜组织。所有患者均接受了关于饮食和营养补充的详细指导。两份样本同时进行免疫组织化学和蛋白质印迹分析。样本由病理学家进行分析。采用χ²检验和Wilcoxon检验进行统计学分析。
共招募了16例患者，其中13例完成了研究。12例为女性。平均年龄和体重指数（BMI）分别为44.1和40.4。在研究期间，体重和BMI均显著下降，平均超重体重减轻百分比（%EWL）为60%±13.3%，平均超重BMI减轻百分比（%EBMIL）为79.6%±21.6%。术后6个月仅有2例患者出现轻度贫血，但其铁蛋白水平仍在正常范围内。DMT1染色显示，位于绒毛顶端的肠细胞胞质中DMT1显著增加（χ² = 6.03；P = 0.049）。然而，DMT1的总量显著减少（Z = 2.04；P = 0.04）。与这些结果相关的是，我们观察到术后6个月绒毛中的杯状细胞显著增加（Z = -2.47；P = 0.013）。
RYGB手术后6个月，患者近端空肠绒毛顶端肠细胞中的DMT1表达增加。
