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选择性迷走神经切断术会加重回肠转位术后的血糖控制。

Selective Vagotomy Worsens Glucose Control After Ileal Transposition.

机构信息

Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Beijing, 100730, People's Republic of China.

Clinical Laboratory of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Beijing, 100730, People's Republic of China.

出版信息

Obes Surg. 2018 Aug;28(8):2494-2499. doi: 10.1007/s11695-018-3192-1.

Abstract

PURPOSES

Our aim was to investigate the effects of selective celiac branch vagotomy on food intake and glycemic control after ileal transposition (IT) and the possible roles of the vagus on the improvement of diabetes.

MATERIALS AND METHODS

Forty non-obese rats with diabetes underwent either IT, IT + celiac branch vagotomy (ITV), sham IT (SI), or sham IT + celiac branch vagotomy (SIV). They were pair fed, and the food intake, body weight, fasting plasma glucose, and glucagon-like peptide 1 (GLP-1) level were monitored. The number of activated pro-opiomelanocortin (POMC) neurons and POMC-derived peptides were measured after sacrifice.

RESULTS

The fasting glucose level of the ITV group was higher (7.0 ± 0.7 mmol/L vs. 5.7 ± 0.3, P = 0.01), and the area under the curve of the oral glucose tolerance test (AUC) value was greater than that of the IT group (1101.8 ± 90.3 (mmol/l) min vs. 986.9 ± 47.7 (mmol/l) min, P = 0.01). There was no significant difference in the postprandial GLP-1 level between these two groups, but the number of activated neurons in the ITV group was less than that of the IT group (10.3 ± 2.1 vs. 14.9 ± 2.3, P < 0.01), while the relative content level of POMC-derived peptides in the ITV group was half that of the IT group (P < 0.01).

CONCLUSIONS

The celiac branches of the vagus might contribute to less eating and improvement of diabetes after IT. The activating vagus strategy might be a goal for the treatment of diabetes.

摘要

目的

本研究旨在探讨选择性腹腔分支迷走神经切断术对回肠转位(IT)后食物摄入和血糖控制的影响,以及迷走神经在改善糖尿病中的可能作用。

材料和方法

40 只非肥胖型糖尿病大鼠接受 IT、IT+腹腔分支迷走神经切断术(ITV)、假 IT(SI)或假 IT+腹腔分支迷走神经切断术(SIV)。它们进行配对喂养,监测食物摄入量、体重、空腹血糖和胰高血糖素样肽 1(GLP-1)水平。处死大鼠后测量激活的前阿黑皮素原(POMC)神经元和 POMC 衍生肽的数量。

结果

与 IT 组相比,ITV 组空腹血糖水平更高(7.0±0.7mmol/L 比 5.7±0.3mmol/L,P=0.01),口服葡萄糖耐量试验(OGTT)曲线下面积(AUC)值更大(1101.8±90.3mmol/l min 比 986.9±47.7mmol/l min,P=0.01)。两组餐后 GLP-1 水平无显著差异,但 ITV 组激活神经元数量少于 IT 组(10.3±2.1 比 14.9±2.3,P<0.01),而 ITV 组 POMC 衍生肽的相对含量为 IT 组的一半(P<0.01)。

结论

腹腔分支迷走神经可能有助于 IT 后减少进食和改善糖尿病。激活迷走神经的策略可能是治疗糖尿病的一个目标。

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