Puerta del Mar Hospital, University of Cadiz, Cadiz, Spain.
Asociación Gaditana de Apoyo al Investigador, Cadiz, Spain.
Obes Surg. 2020 Feb;30(2):697-706. doi: 10.1007/s11695-019-04239-y.
Roux-en-Y gastric bypass (RYGB) is one of the most effective surgical therapies for the rapid resolution of type 2 diabetes. However, the mechanisms underlying the entero-hormonal response after surgery and the role of peptide tyrosine tyrosine (PYY) in the restoration of normoglycemia are still not clear.
We reproduced the RYGB technique in Wistar and Goto-Kakizaki rats and performed serum hormonal, histological, and hormonal-infusion test.
Using the diabetic Goto-Kakizaki (GK) rat model, we demonstrated that PYY plasma levels showed a remarkable peak approximately 30 min earlier than GLP-1 or GIP after mixed-meal administration in RYGB-operated rats with PYY. The GLP-1 and GIP areas under the curve (AUCs) increased after RYGB in GK rats. Additionally, the findings suggested that PYY (3-36) infusion led to increased GLP-1 and GIP plasma levels close to those obtained after a meal. Finally, the number of GLP-1-positive cells appeared to increase in the three segments of the small intestine in GK-RYGB-operated rats beyond the early presence of nutrient stimulation in the ileum. Nevertheless, PYY-positive cell numbers appeared to increase only in the ileum.
At least in rats, these data demonstrate an earlier essential role for PYY in gut hormone regulation after RYGB. We understand that PYY contributes to GLP-1 and GIP release and there must be the existence of enteroendocrine communication routes between the distal and proximal small intestine.
Roux-en-Y 胃旁路（RYGB）是快速解决 2 型糖尿病的最有效手术治疗方法之一。然而，手术后肠激素反应的机制以及肽酪氨酸酪氨酸（PYY）在恢复正常血糖水平中的作用尚不清楚。
我们在 Wistar 和 Goto-Kakizaki 大鼠中复制了 RYGB 技术，并进行了血清激素、组织学和激素输注试验。
使用糖尿病 Goto-Kakizaki（GK）大鼠模型，我们证明了 PYY 血浆水平在 RYGB 手术后混合餐给药后，比 GLP-1 或 GIP 提前约 30 分钟出现显著峰值。在 GK 大鼠中，RYGB 后 GLP-1 和 GIP 的曲线下面积（AUC）增加。此外，研究结果表明，PYY（3-36）输注可使 GLP-1 和 GIP 血浆水平升高，接近餐后水平。最后，在 GK-RYGB 手术大鼠的小肠三个节段中，GLP-1 阳性细胞的数量似乎在回肠中营养刺激的早期就增加了。然而，PYY 阳性细胞的数量似乎仅在回肠中增加。
至少在大鼠中，这些数据表明 PYY 在 RYGB 后肠道激素调节中具有更早的重要作用。我们认为 PYY 有助于 GLP-1 和 GIP 的释放，并且在远端和近端小肠之间必须存在肠内分泌通讯途径。
