Brain Korea 21 PLUS Project for Medical Science, Yonsei University, College of Medicine, Seoul, South Korea.
Department of Internal Medicine, Endocrinology, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, South Korea.
Front Endocrinol (Lausanne). 2022 Jul 14;13:937394. doi: 10.3389/fendo.2022.937394. eCollection 2022.
The Roux-en-Y gastric bypass (RYGB) is highly effective in the remission of obesity and associated diabetes. The mechanisms underlying obesity and type 2 diabetes mellitus remission after RYGB remain unclear. This study aimed to evaluate the changes in continuous dynamic FDG uptake patterns after RYGB and examine the correlation between glucose metabolism and its transporters in variable endocrine organs using F-fluoro-2-deoxyglucose positron emission tomography images. Increased glucose metabolism in specific organs, such as the small intestine and various fat tissues, is closely associated with improved glycemic control after RYGB. In Otsuka Long-Evans Tokushima Fatty rats fed with high-fat diets, RYGB operation increases intestine glucose transporter expression and various fat tissues' glucose transporters, which are not affected by insulin. The fasting glucose decrement was significantly associated with RYGB, sustained weight loss, post-RYGB oral glucose tolerance test (OGTT) area under the curve (AUC), glucose transporter, or glycolytic enzymes in the small bowel and various fat tissues. High intestinal glucose metabolism and white adipose tissue-dependent glucose metabolism correlated with metabolic benefit after RYGB. These findings suggest that the newly developed glucose biodistribution accompanied by increased glucose transporters is a mechanism associated with the systemic effect of RYGB.
胃旁路术(RYGB)在肥胖症和相关糖尿病的缓解方面非常有效。RYGB 后肥胖症和 2 型糖尿病缓解的机制仍不清楚。本研究旨在评估 RYGB 后连续动态 FDG 摄取模式的变化,并使用 F-氟-2-脱氧葡萄糖正电子发射断层扫描图像检查可变内分泌器官中葡萄糖代谢及其转运蛋白之间的相关性。特定器官(如小肠和各种脂肪组织)的葡萄糖代谢增加与 RYGB 后血糖控制的改善密切相关。在高脂饮食喂养的 Otsuka Long-Evans Tokushima 肥胖大鼠中,RYGB 手术增加了肠道葡萄糖转运蛋白的表达和各种脂肪组织的葡萄糖转运蛋白,这些不受胰岛素影响。空腹血糖下降与 RYGB、持续体重减轻、RYGB 后口服糖耐量试验(OGTT)曲线下面积(AUC)、小肠和各种脂肪组织中的葡萄糖转运蛋白或糖酵解酶显著相关。高肠道葡萄糖代谢和白色脂肪组织依赖性葡萄糖代谢与 RYGB 后的代谢益处相关。这些发现表明,新出现的葡萄糖分布与葡萄糖转运蛋白增加伴随的葡萄糖代谢是与 RYGB 全身效应相关的机制。