Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism, Weill Cornell Medical College, 1165 York Avenue, New York, NY, 10065, USA.
Comprehensive Medical Weight Management, Department of Bariatric Surgery, Hartford HealthCare Medical Group, Hartford, CT, USA.
Curr Obes Rep. 2018 Jun;7(2):139-146. doi: 10.1007/s13679-018-0302-2.
This paper will review the intestinal and gastric origins for diabetes resolution after bariatric surgery.
In addition to the known metabolic effects of changes in the gut hormonal milieu, more recent studies investigating the role of the microbiome and bile acids and changes in nutrient sensing mechanisms have been shown to have glycemic effects in human and animal models. Independent of weight loss, there are multiple mechanisms that may lead to amelioration or resolution of diabetes following bariatric surgery. There is abundant evidence pointing to changes in gut hormones, bile acids, gut microbiome, and intestinal nutrient sensing; more research is needed to clearly delineate their role in regulating energy and glucose homeostasis after bariatric surgery.
本文将综述减重手术后糖尿病缓解的肠道和胃部起源。
除了肠道激素环境变化的已知代谢作用外，最近的研究调查了微生物组和胆汁酸的作用以及营养感应机制的变化，这些研究在人类和动物模型中显示出具有血糖作用。独立于体重减轻，有多种机制可能导致减重手术后糖尿病的改善或缓解。有大量证据表明肠道激素、胆汁酸、肠道微生物组和肠道营养感应发生变化；需要更多的研究来明确它们在调节减重手术后能量和葡萄糖稳态中的作用。
