Song Weiguo, Qanud Khaled, Thompson Dane A, Huston Jared M, Zanos Stavros
Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research at Northwell Health, Manhasset, NY, 11030, USA.
Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, NY, 11042, USA.
Bioelectron Med. 2025 Jun 18;11(1):14. doi: 10.1186/s42234-025-00176-7.
Metabolic stress during major surgery increases insulin resistance and causes post-operative hyperglycemia (POHG), which may in turn contribute to post-operative morbidity and mortality. Intensive insulin therapy for POHG is often ineffective and may even worsen patient outcomes. Non-invasive focused ultrasound stimulation (FUS) of glucose-sensing abdominal neurons improves glucose metabolism in animal models of diabetes, but its potential role in treating POHG remains unknown. In this study, we explored whether FUS of the superior mesenteric plexus (SMP) alters insulin sensitivity and post-operative fasting blood glucose (FBG) in a swine model of surgical stress-induced POHG. In each of 3 anesthetized animals, FUS targeting the porta hepatis (PH) of the liver or the SMP was delivered and insulin sensitivity was assessed in each case. In another series of experiments, 4 animals received SMP-FUS and 3 sham stimulation, after which surgical stress was induced via small bowel resection. In the 7 surgically operated animals, insulin sensitivity was measured before and after SMP-FUS (or sham), and fasting blood glucose (FBG) was measured before and 16 h after surgery. In all animals, insulin sensitivity was assessed using the hyperinsulinemic-euglycemic clamp (HEC) method. Results: SMP-FUS elicits a greater increase in insulin sensitivity than PH-FUS. On the day of surgery, SMP-FUS increases insulin sensitivity, compared to sham treatment. The day after surgery, surgically operated animals develop mild hyperglycemia. SMP-FUS-treated animals have higher FBG than sham-FUS-treated animals. No clear relationship is observed between FUS-induced changes in insulin sensitivity and next-day FBG. Conclusion: While SMP-FUS improves insulin sensitivity during surgery, it may exacerbate POHG.
大手术期间的代谢应激会增加胰岛素抵抗并导致术后高血糖（POHG），这反过来可能会导致术后发病率和死亡率上升。针对POHG的强化胰岛素治疗往往无效，甚至可能使患者的预后更差。对葡萄糖敏感的腹部神经元进行非侵入性聚焦超声刺激（FUS）可改善糖尿病动物模型的葡萄糖代谢，但其在治疗POHG中的潜在作用仍不清楚。在本研究中，我们探讨了肠系膜上神经丛（SMP）的FUS是否会改变手术应激诱导的POHG猪模型中的胰岛素敏感性和术后空腹血糖（FBG）。在3只麻醉动物中，分别对肝脏肝门（PH）或SMP进行FUS，并评估每种情况下的胰岛素敏感性。在另一系列实验中，4只动物接受SMP-FUS，3只接受假刺激，然后通过小肠切除术诱导手术应激。在7只接受手术的动物中，在SMP-FUS（或假刺激）前后测量胰岛素敏感性，并在手术前和术后16小时测量空腹血糖（FBG）。在所有动物中，使用高胰岛素-正常血糖钳夹（HEC）方法评估胰岛素敏感性。结果：与PH-FUS相比，SMP-FUS引起的胰岛素敏感性增加更大。在手术当天，与假治疗相比，SMP-FUS可提高胰岛素敏感性。手术后一天，接受手术的动物出现轻度高血糖。接受SMP-FUS治疗的动物的FBG高于接受假FUS治疗的动物。未观察到FUS诱导的胰岛素敏感性变化与次日FBG之间存在明确关系。结论：虽然SMP-FUS在手术期间可提高胰岛素敏感性，但可能会加剧POHG。
