Maimaitiyusufu Wubulikasimu, Han Haifeng, Yan Zhibo, Zhang Xiang, Liu Shaozhuang, Zhang Guangyong, Kasimu Aimaiti, Hu Sanyuan
Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China. Email:
Chin Med J (Engl). 2014;127(13):2423-8.
Bariatric surgery offers a productive resolution of type 2 diabetes mellitus (T2DM). The development of T2DM vasculopathy is due to chronic inflammation, which increases matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) expression. This study sought to examine MMP-9 and TIMP-1 expression in the thoracic aorta after duodenal-jejunal bypass (DJB) surgery on a T2DM rat model induced by a high-fat diet and low dose streptozotocin (STZ).
Twenty-one T2DM Wistar rats induced by high-fat diet and low dose STZ were randomly divided into DJB and sham duodenal-jejunal bypass (S-DJB) groups. Ten Wistar rats were fed a normal diet as a control. Recovery of gastrointestinal function post-operation and resumption of a normal diet completed the experiment. Body weight, blood glucose, blood lipid levels, and MMP-9 and TIMP-1 expression levels in aortic endothelial cells were measured throughout.
DJB rats showed significant weight loss 2 weeks post-operation compared with S-DJB rats. After surgery, DJB rats showed significant improvement and steady glycemic control with improved insulin sensitivity and glucose tolerance. They also exhibited improved lipid metabolism with a decrease in fasting free fatty acids (FFAs) and triglycerides (all P < 0.05). Immunohistochemistry showed decreased MMP-9 and TIMP-1 expression 12 weeks after surgery (P < 0.01).
DJB surgery on an induced T2DM rat model improves blood glucose levels and lipids, following a high-fat diet and low dose STZ treatment. In addition, DJB decreased MMP-9 and TIMP-1 expression in vascular endothelial cells, which may play an important role in delaying the development of T2DM vascular disease.
减重手术为2型糖尿病(T2DM)提供了有效的治疗方案。T2DM血管病变的发生是由于慢性炎症,其会增加基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶组织抑制剂-1(TIMP-1)的表达。本研究旨在检测十二指肠空肠旁路术(DJB)对高脂饮食联合低剂量链脲佐菌素(STZ)诱导的T2DM大鼠模型胸主动脉中MMP-9和TIMP-1表达的影响。
将21只高脂饮食联合低剂量STZ诱导的T2DM雄性Wistar大鼠随机分为DJB组和假十二指肠空肠旁路术(S-DJB)组。10只Wistar大鼠给予正常饮食作为对照。术后胃肠功能恢复及恢复正常饮食后完成实验。全程测量体重、血糖、血脂水平以及主动脉内皮细胞中MMP-9和TIMP-1的表达水平。
与S-DJB组相比,DJB组大鼠术后2周体重显著减轻。术后,DJB组大鼠血糖得到显著改善并稳定控制,胰岛素敏感性和糖耐量提高。它们的脂质代谢也得到改善,空腹游离脂肪酸(FFA)和甘油三酯降低(均P<0.05)。免疫组化显示术后12周MMP-9和TIMP-1表达降低(P<0.01)。
高脂饮食联合低剂量STZ处理后,对诱导的T2DM大鼠模型进行DJB手术可改善血糖水平和血脂。此外,DJB降低了血管内皮细胞中MMP-9和TIMP-1的表达,这可能在延缓T2DM血管疾病的发展中起重要作用。