Ward 1, Department of General Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi, China.
Eur Rev Med Pharmacol Sci. 2020 Oct;24(20):10653-10662. doi: 10.26355/eurrev_202010_23423.
To explore the effect of sleeve gastrectomy on type 2 diabetes mellitus (T2DM) in regulating ghrelin and intestinal lesions.
Specific pathogen free (SPF) Wistar rats were injected with streptozotocin (STZ) after giving a high-sugar and high-fat diet, to establish a T2DM rat model. The rats were randomly divided into a sleeve gastric excision group, a non-surgical group and a fake surgical group, with 10 rats in each group. The weight, blood glucose, glucose tolerance and ghrelin hormone of rats were compared. The feces of rats in each group at the 8th week after surgery were collected, to extract the total bacterial deoxyribonucleic acid (DNA). The bacterial 16S universal primer was used to expand the 16SrRNA V46 conserved region. The total Polymerase Chain Reaction (PCR) products were sequenced by PE101-bp to classify the gene and genera.
The weight of the rats after sleeve gastrectomy significantly decreased (p <0.05). The area under the blood glucose curve and the area under the insulin curve were significantly smaller than those in the non-surgical group and the fake surgical group (p <0.05). Compared with the sleeve gastric excision group, the abundance of Phylum Firmicutes was higher, that of Bacteroidetes was lower. Compared with the sleeve gastric excision group, there were more genera in the fake surgical group and the non-surgical group. The genera with higher abundance in the three groups were Lactobacillus and Bacteroidetes. Compared with the sleeve gastric excision group, the fake surgical group and the non-surgical group had higher abundance of Phylum Firmicutes (p <0.05) and lower abundance of Bacteroidetes (p <0.05).
To sum up, sleeve gastrectomy can reduce the weight of rats in T2DM rat model, lower blood glucose levels of rats in the model and improve insulin resistance levels. The related mechanism may be related to the upregulation of ghrelin and intestinal flora.
探讨袖状胃切除术对 2 型糖尿病（T2DM）调节胃饥饿素和肠道病变的影响。
给予 SPF 大鼠高糖高脂饮食并注射链脲佐菌素（STZ），建立 T2DM 大鼠模型。将大鼠随机分为袖状胃切除组、非手术组和假手术组，每组 10 只。比较各组大鼠体重、血糖、葡萄糖耐量和胃饥饿素激素水平。术后第 8 周收集各组大鼠粪便，提取总细菌脱氧核糖核酸（DNA）。采用细菌 16S 通用引物扩增 16SrRNA V46 保守区，采用 PE101-bp 对总聚合酶链反应（PCR）产物进行测序，对基因和属进行分类。
袖状胃切除术后大鼠体重明显减轻（p<0.05）。血糖曲线下面积和胰岛素曲线下面积明显小于非手术组和假手术组（p<0.05）。与袖状胃切除组相比，厚壁菌门的丰度较高，拟杆菌门的丰度较低。与袖状胃切除组相比，假手术组和非手术组的属较多。三个组中丰度较高的属为乳杆菌属和拟杆菌属。与袖状胃切除组相比，假手术组和非手术组厚壁菌门丰度较高（p<0.05），拟杆菌门丰度较低（p<0.05）。
综上所述，袖状胃切除术可降低 T2DM 大鼠模型大鼠体重，降低模型大鼠血糖水平，改善胰岛素抵抗水平。其相关机制可能与胃饥饿素和肠道菌群上调有关。
