Division of Nuclear Medicine, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
Research Division, Joslin Diabetes Center, and Harvard Medical School, Boston, Massachusetts.
Surg Obes Relat Dis. 2019 Apr;15(4):643-649. doi: 10.1016/j.soard.2019.01.018. Epub 2019 Jan 25.
Mechanisms of metabolic improvement after bariatric surgery remain incompletely understood. Intestinal glucose uptake is increased after gastric bypass in rodents, potentially contributing to reduced blood glucose and type 2 diabetes remission.
We assessed whether intestinal glucose uptake is increased in humans after gastric surgery.
University Hospital, United States.
In a retrospective, case-control cohort study, positron emission tomography-computerized tomography scans performed for clinical indications were analyzed to quantify intestinal glucose uptake in patients with or without history of gastric surgery. We identified 19 cases, defined as patients over age 18 with prior gastric surgery (Roux-en-Y gastric bypass [n = 10], sleeve gastrectomy [n = 1], or Billroth I [n = 2] or II gastrectomy [n = 6]), and 43 controls without gastric surgery, matched for age, sex, and indication for positron emission tomography-computerized tomography. Individuals with gastrointestinal malignancy or metformin treatment were excluded. Images were obtained 60 minutes after F-fluorodeoxyglucose injection (4.2 MBq/kg), and corrected by attenuation; noncontrast low-dose computerized tomography was obtained in parallel. Fused and nonfused images were analyzed; standardized uptake values were calculated for each region by volumes of interest at the region of highest activity.
Both standardized uptake values maximum and mean were significantly increased by 41% to 98% in jejunum, ascending, and transverse colon in patients with prior gastric surgery (P < .05 versus controls).
Intestinal glucose uptake is increased in patients with prior gastric surgery. Prospective studies are important to dissect the contributions of weight loss, dietary factors, and systemic metabolism, and to determine the relationship with increased insulin-independent glucose uptake and reductions in glycemia.
减重手术后代谢改善的机制仍不完全清楚。肠葡萄糖摄取在啮齿动物胃旁路手术后增加，可能有助于降低血糖和 2 型糖尿病缓解。
我们评估胃手术后人类的肠葡萄糖摄取是否增加。
美国大学医院。
在回顾性病例对照队列研究中，对出于临床指征进行的正电子发射断层扫描-计算机断层扫描进行分析，以定量评估有或无胃手术史的患者的肠葡萄糖摄取。我们确定了 19 例病例，定义为年龄大于 18 岁且有胃手术史的患者（Roux-en-Y 胃旁路术[ n = 10]、袖状胃切除术[n = 1]、Billroth I[n = 2]或 II[n = 6]胃切除术），以及 43 例无胃手术的对照，按年龄、性别和正电子发射断层扫描-计算机断层扫描的指征匹配。排除有胃肠道恶性肿瘤或二甲双胍治疗的患者。在注射 F-氟脱氧葡萄糖后 60 分钟（4.2 MBq/kg）获得图像，并通过衰减进行校正；同时获得非对比低剂量计算机断层扫描。对融合和非融合图像进行分析；通过每个区域的兴趣区计算每个区域的标准化摄取值。
胃手术患者的空肠、升结肠和横结肠的标准化摄取最大值和平均值分别显著增加 41%至 98%（P <.05 与对照组）。
胃手术患者的肠葡萄糖摄取增加。前瞻性研究对于剖析体重减轻、饮食因素和全身代谢的贡献以及确定与胰岛素非依赖性葡萄糖摄取增加和血糖降低的关系很重要。
