Ding Huanxin, Zhang Yun, Ma Xiaomin, Zhang Zhongwen, Xu Qian, Liu Chuxuan, Li Bingjun, Dong Shuohui, Li Linchuan, Zhu Jiankang, Zhong Mingwei, Zhang Guangyong
Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China.
Front Pharmacol. 2022 Oct 21;13:1016635. doi: 10.3389/fphar.2022.1016635. eCollection 2022.
Continuously rising trends in diabetes render this disease spectrum an epidemic proportion worldwide. As the disease progresses, the pathological effects of diabetes may impair the normal function of several vital organs, eventually leading to increase the risk of other diabetic comorbidities with advanced fibrosis such as non-alcoholic fatty liver disease, diabetic cardiomyopathy, and diabetic kidney disease. Currently, lifestyle changes and drug therapies of hypoglycemic and lipid-lowering are effective in improving multi-organ function, but therapeutic efficacy is difficult to maintain due to poor compliance and drug reactions. Bariatric surgery, including sleeve gastrectomy and Roux-en-Y gastric bypass surgery, has shown better results in terms of prognosis for diabetes through long-term follow-up. Moreover, bariatric surgery has significant long-term benefits on the function of the heart, liver, kidneys, and other organs through mechanisms associated with reversal of tissue fibrosis. The aim of this review is to describe the impact of type 2 diabetes mellitus on hepatic, cardiac and renal fibrosis and to summarize the potential mechanisms by which bariatric surgery improves multiple organ function, particularly reversal of fibrosis.
糖尿病的持续上升趋势使这种疾病在全球范围内呈现出流行态势。随着疾病的进展，糖尿病的病理影响可能会损害多个重要器官的正常功能，最终导致其他伴有晚期纤维化的糖尿病合并症风险增加，如非酒精性脂肪性肝病、糖尿病心肌病和糖尿病肾病。目前，生活方式的改变以及降糖和降脂药物治疗在改善多器官功能方面是有效的，但由于依从性差和药物反应，治疗效果难以维持。包括袖状胃切除术和Roux-en-Y胃旁路手术在内的减重手术，通过长期随访显示出在糖尿病预后方面有更好的效果。此外，减重手术通过与组织纤维化逆转相关的机制，对心脏、肝脏、肾脏和其他器官的功能具有显著的长期益处。本综述的目的是描述2型糖尿病对肝、心和肾纤维化的影响，并总结减重手术改善多器官功能，特别是逆转纤维化的潜在机制。
