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肠切除相关代谢综合征

Intestinal resection-associated metabolic syndrome.

作者信息

Barron Lauren, Courtney Cathleen, Bao James, Onufer Emily, Panni Roheena Z, Aladegbami Bola, Warner Brad W

机构信息

Division of Pediatric Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; St. Louis Children's Hospital, St. Louis, MO, USA.

Division of Pediatric Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; St. Louis Children's Hospital, St. Louis, MO, USA.

出版信息

J Pediatr Surg. 2018 Jun;53(6):1142-1147. doi: 10.1016/j.jpedsurg.2018.02.077. Epub 2018 Mar 7.

Abstract

BACKGROUND

Short bowel syndrome occurs following massive small bowel resection (SBR) and is one of the most lethal diseases of childhood. We have previously demonstrated hepatic steatosis, altered gut microbiome, and increased fat deposition in our murine model of SBR. These novel findings prompted us to investigate potential alterations in glucose metabolism and systemic inflammation following intestinal resection.

METHODS

Male C57BL6 mice underwent 50% proximal SBR or sham operation. Body weight and composition were measured. Fasting blood glucose (FBG), glucose, and insulin tolerance testing were performed. Small bowel, pancreas, and serum were collected at sacrifice and analyzed.

RESULTS

SBR mice gained less weight than shams after 10weeks. Despite this, FBG in resected mice was significantly higher than sham animals. After SBR, mice demonstrated perturbed body composition, higher blood glucose, increased pancreatic islet area, and increased systemic inflammation compared with sham mice. Despite these changes, we found no alteration in insulin tolerance after resection.

CONCLUSIONS

After massive SBR, we present evidence for abnormal body composition, glucose metabolism, and systemic inflammation. These findings, coupled with resection-associated hepatic steatosis, suggest that massive SBR (independent of parenteral nutrition) results in metabolic consequences not previously described and provides further evidence to support the presence of a novel resection-associated metabolic syndrome.

摘要

背景

短肠综合征发生于大量小肠切除术后,是儿童期最致命的疾病之一。我们之前在小鼠短肠切除模型中证实了肝脂肪变性、肠道微生物群改变以及脂肪沉积增加。这些新发现促使我们研究肠道切除术后糖代谢和全身炎症的潜在变化。

方法

雄性C57BL6小鼠接受50%近端小肠切除术或假手术。测量体重和身体组成。进行空腹血糖(FBG)、葡萄糖和胰岛素耐量试验。处死小鼠时收集小肠、胰腺和血清并进行分析。

结果

10周后,小肠切除小鼠的体重增长低于假手术组。尽管如此,切除术后小鼠的空腹血糖显著高于假手术组动物。与假手术小鼠相比,小肠切除术后小鼠的身体组成紊乱、血糖升高、胰岛面积增加且全身炎症反应增强。尽管有这些变化,但我们发现切除术后胰岛素耐量没有改变。

结论

大量小肠切除术后,我们提供了身体组成、糖代谢和全身炎症异常的证据。这些发现,再加上与切除相关的肝脂肪变性,表明大量小肠切除术(独立于肠外营养)会导致以前未描述的代谢后果,并为支持存在一种新的与切除相关的代谢综合征提供了进一步的证据。

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引用本文的文献

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Short Bowel Syndrome.短肠综合征
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本文引用的文献

1
Pediatric intestinal failure-associated liver disease.小儿肠衰竭相关肝病
Curr Opin Pediatr. 2017 Jun;29(3):363-370. doi: 10.1097/MOP.0000000000000484.
5
Fatty liver disease in diabetes mellitus.糖尿病中的脂肪肝疾病
Hepatobiliary Surg Nutr. 2015 Apr;4(2):101-8. doi: 10.3978/j.issn.2304-3881.2015.01.03.
10

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