胃旁路手术改善小鼠的葡萄糖和脂代谢。
Esophagus-duodenum Gastric Bypass Surgery Improves Glucose and Lipid Metabolism in Mice.
机构信息
Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China; Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Key Laboratory of Reproduction and Genetic of Ningxia Hui Autonomous Region, School of Basic Medicine, Ningxia Medical University, Shengli Street No.1160, Yinchuan 750004, China.
Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China.
出版信息
EBioMedicine. 2018 Feb;28:241-250. doi: 10.1016/j.ebiom.2018.01.032. Epub 2018 Feb 3.
BACKGROUND
Despite of its significant therapeutic effects on obesity and metabolic diseases, Roux-en-Y gastric bypass (RYGB) has limited clinical application because of considerable impacts on the gastrointestinal structure and postoperative complications. This study aims to develop a simplified surgical approach with less damage and complication but efficient metabolic benefit.
METHODS
The effects of Esophagus-Duodenum gastric bypass (EDGB) on body weight, food intake, glucose and lipid metabolism were compared to RYGB in mice.
FINDINGS
EDGB is simple, has higher survival rate and less complication. Relative to RYGB, EDGB demonstrated modest body weight control, identical improvement of glucose and lipid metabolism in obese mice. Blood glucose increased significantly 15 and 30min after oral glucose administration, then markedly decreased in both EDGB and RYGB groups relative to the sham surgery, indicating a quicker absorption of oral glucose and improvement in glucose uptake by insulin targeted tissues. Insulin sensitivity was identically improved. EDGB significantly decreased plasma and hepatic triglyceride levels, while increased browning in visceral and subcutaneous white adipose tissue to the extent identical to RYGB. Levels of ghrelin and nesfatin-1 increased significantly after EDGB and RYGB.
INTERPRETATION
EDGB is a valuable model to study the metabolic benefit of bariatric surgery in mice.
背景
尽管胃旁路术（RYGB）在肥胖和代谢疾病的治疗方面具有显著的效果，但由于对胃肠道结构的重大影响和术后并发症，其临床应用受到限制。本研究旨在开发一种损伤和并发症较小但代谢效益较高的简化手术方法。
方法
比较了食管十二指肠胃旁路术（EDGB）与 RYGB 对肥胖小鼠体重、食物摄入、葡萄糖和脂质代谢的影响。
发现
EDGB 手术简单，存活率更高，并发症更少。与 RYGB 相比，EDGB 对肥胖小鼠的体重控制效果相当，对葡萄糖和脂质代谢的改善效果相同。口服葡萄糖后，血糖在 15 和 30 分钟时显著升高，然后在 EDGB 和 RYGB 组相对于假手术组明显下降，表明口服葡萄糖吸收更快，胰岛素靶向组织的葡萄糖摄取得到改善。胰岛素敏感性同样得到改善。EDGB 显著降低了血浆和肝甘油三酯水平，同时使内脏和皮下白色脂肪组织的棕色化程度与 RYGB 相同。EDGB 和 RYGB 后，ghrelin 和 nesfatin-1 的水平显著升高。
结论
EDGB 是研究肥胖症小鼠减重手术代谢效益的有价值模型。
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