Graduate Institute of Sports Training, Institute of Sports Sciences, University of Taipei, Taipei, Taiwan.
Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine and Institute of Emergency and Critical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Institutional Review Board, Taipei Veterans General Hospital, Taipei, Taiwan; Taiwan Association for the Study of Small Intestinal Diseases, Guishan, Taoyuan, Taiwan; Chinese Taipei Society for the Study of Obesity, Taipei, Taiwan; World Health Organization-Strategic Initiative for Developing Capacity in Ethical Review/Forum for Ethical Review Committees in the Asian and Western Pacific Region, Pathumthani, Thailand.
Obes Res Clin Pract. 2020 Nov-Dec;14(6):504-507. doi: 10.1016/j.orcp.2020.09.001. Epub 2020 Sep 18.
Several strategies are being pursued to overcome the alarming pandemics of obesity and type 2 diabetes (T2D). In recent years, duodenal mucosal resurfacing (DMR) has shown its potential to improve glycemic indices. Following animal studies, which demonstrated feasibility and safety, the procedure has been applied in two human studies. The DMR procedure has been considered feasible and safe in humans with a limited occurrence of complications and adverse events. Reductions in glycated haemoglobin, weight, fasting plasma glucose, and alanine transaminase have been proven at different follow-up time-points. The length of the ablation may induce different outcomes, having the patients with long duodenal segment ablated showed greater beneficial effects. The current evidence does not still prove the apparent insulin-sensitizing mechanism explaining the impact of the DMR procedure on hepatic glucose production. However, the initial findings have demonstrated a positive risk-benefit ratio and an effect on the treatment of metabolic diseases, such as T2D. Future studies should clarify the mechanisms underlying the positive effects and durability of the treatment using controlled trial conditions on larger number of patients.
目前正在采取多种策略来应对肥胖症和 2 型糖尿病（T2D）的惊人流行。近年来，十二指肠黏膜表面重建（DMR）已显示出改善血糖指数的潜力。在动物研究证明了其可行性和安全性之后，该程序已在两项人类研究中得到应用。在发生并发症和不良事件的频率有限的情况下，DMR 程序在人类中被认为是可行且安全的。在不同的随访时间点都证明了糖化血红蛋白、体重、空腹血糖和丙氨酸转氨酶的降低。消融的长度可能会产生不同的结果，接受长段十二指肠消融的患者显示出更大的有益效果。目前的证据还不能证明明显的胰岛素增敏机制可以解释 DMR 程序对肝葡萄糖生成的影响。然而，初步发现表明，该程序在治疗代谢疾病（如 T2D）方面具有积极的风险效益比和效果。未来的研究应该在更大数量的患者中，使用对照试验条件，阐明治疗效果的潜在机制及其持久性。
