Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA.
Ren Fail. 2020 Nov;42(1):624-628. doi: 10.1080/0886022X.2020.1790389.
Bariatric surgery is known to attenuate glomerular hyperfiltration over the long term and thereby protect the kidney from mechanical damage. Whether this effect is directly related to weight loss or is independent of weight as are some of its other beneficial metabolic effects is not known. We explored this question in a preliminary study that directly measured glomerular filtration rate (GFR) before, immediately after, and again many months after Roux-en-Y gastric bypass after large weight loss had occurred. We simultaneously measured stimulated circulating glucagon-like peptide-1, which is upregulated after Roux-en-Y gastric bypass and is a putative mediator of GFR after bariatric surgery. We found no weight-independent effect of Roux-en-Y gastric bypass on GFR nor an association between circulating GLP-1 levels and GFR. These findings, if confirmed in larger studies, will help steer future enquiries in this area.
减重手术已知可长期减轻肾小球高滤过，从而保护肾脏免受机械损伤。其一些有益的代谢作用并非直接与体重减轻相关，而是独立于体重，目前尚不清楚这种作用是否与体重减轻直接相关。我们在一项初步研究中探讨了这个问题，该研究在 Roux-en-Y 胃旁路手术后发生大量体重减轻之前、之后立即以及之后的多个月直接测量了肾小球滤过率（GFR）。我们同时测量了刺激后循环胰高血糖素样肽-1（GLP-1），该肽在 Roux-en-Y 胃旁路手术后上调，是减重手术后 GFR 的潜在介导物。我们发现 Roux-en-Y 胃旁路手术对 GFR 没有独立于体重的影响，也没有循环 GLP-1 水平与 GFR 之间的关联。如果在更大的研究中得到证实，这些发现将有助于指导该领域未来的研究。
