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十二指肠-空肠转流手术对2型糖尿病大鼠胰岛素抵抗的改善作用
引用本文:王龙霞,赵先哲,乔伟伟,顾坚忠,陈立新.十二指肠-空肠转流手术对2型糖尿病大鼠胰岛素抵抗的改善作用[J].实验动物与比较医学,2015,23(2):159-164.
作者姓名:王龙霞  赵先哲  乔伟伟  顾坚忠  陈立新
作者单位:复旦大学实验动物科学部, 上海 200032;复旦大学实验动物科学部, 上海 200032;复旦大学实验动物科学部, 上海 200032;上海斯莱克实验动物有限责任公司, 上海 201615;上海斯莱克实验动物有限责任公司, 上海 201615
基金项目:上海市科学技术委员会科研计划项目(No.11140900702)。
摘    要:目的 建立十二指肠-空肠转流手术(duodenal-jejunal bypass surgery, DJB)动物模型, 观察术后GK大鼠胰岛素抵抗情况的变化, 研究DJB手术治疗2型糖尿病的机理。方法 雄性Wistar大鼠为空白对照组;雄性GK大鼠分为模型对照组和DJB手术组。分别于手术后3、6和9周每组随机抽取6只动物进行高胰岛素-正葡萄糖钳夹实验;钳夹实验结束后1周, 检测肝脏GcK、G6P以及PEPCK mRNA表达情况以及骨骼肌细胞膜GLUT4含量变化。结果 术后3周和6周, DJB手术组动物的葡萄糖输注率(GIR)较模型对照组差异无显著性(P>0.05), 肝脏GcK、G6P以及PEPCK mRNA表达量较模型对照组差异无显著性(P>0.05);术后9周, DJB手术组动物的葡萄糖输注率(GIR)显著高于模型对照组(P<0.05), 肝脏GcK表达量DJB手术组显著高于模型对照组(P<0.05), 而G6P以及PEPCK mRNA表达量显著低于模型对照组(P<0.05);DJB手术后3、6和9周, DJB手术组骨骼肌细胞膜GLUT4的含量较模型对照组差异无显著性(P>0.05)。结论 DJB手术改善血糖的水平是通过改善体内肝脏组织的胰岛素抵抗, 通过调节糖代谢酶的表达, 进而提高肝脏葡萄糖摄取并抑制肝脏糖异生作用。在实验周期内, DJB手术对于骨骼肌组织的胰岛素抵抗未发现有明显改善, 提示DJB手术治疗2型糖尿病的效果与时间有一定关系。

关 键 词:2型糖尿病  GK大鼠  十二指肠-空肠转流术  高胰岛素-正葡萄糖钳夹实验
收稿时间:2014/11/3 0:00:00

Amelioration effect of duodenal-jejunal bypass surgery on insulin-resistance in Goto-Kakizaki rats
WANG Long-xi,ZHAO Xian-zhe,QIAO Wei-wei,GU Jian-zhong and CHEN Li-xin.Amelioration effect of duodenal-jejunal bypass surgery on insulin-resistance in Goto-Kakizaki rats[J].Laboratory Animal and Comparative Medicine,2015,23(2):159-164.
Authors:WANG Long-xi  ZHAO Xian-zhe  QIAO Wei-wei  GU Jian-zhong and CHEN Li-xin
Affiliation:Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China;Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China;Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China;Shanghai SLAC Laboratory Animal CO. LTD, Shanghai 201615;Shanghai SLAC Laboratory Animal CO. LTD, Shanghai 201615
Abstract:Objective To establish a Goto-Kakizaki (GK) rat model of duodenal-jejunal bypass(DJB) and observe the changes in insulin-resistance after surgery, and to explore the mechanism of DJB surgery in treatment of type 2 diabetes mellitus. Methods Male Goto-kakizaki diabetic rats(GK, n=36)were used as experiment group and 18 healthy male Wistar rats as blank group. GK rats were randomly divided into two groups: diabetic control group and DJB surgery group (n=18). Euglycemic-hyperinsulinemic clamp technique was performed in 6 rats randomly taken from each group at third week, sixth week and ninth week after surgery, respectively. The expression levels of Gck, G6P, PEPCK mRNA in the liver and GLUT4 content on skeletal muscle cell plasma membrance were detected one week after the clamp test. Results In the DJB surgery group at the end of third week and sixth week after surgery, the levels of glucose infusion rates and the expression levels of Gck, G6P, PEPCK mRNA in the liver showed no statistically significant difference as compared with the diabetic control group (P>0.05). In the DJB surgery group at the end of 9th week after surgery, the glucose infusion rate and expression level of Gck mRNA in the liver were significantly higher, and the expression of G6P and PEPCK mRNA was significantly lower than those in the diabetic control group (P<0.05 for all). At the three time points (3rd week, 6th week and 9th week after surgery), there was no significant difference in the GLUT4 content on skeletal muscle cell plasma membrane between the diabetic control group and DJB surgery group (P>0.05 for all). Conclusions Our results indicate that the mechanism of DJB surgery improving blood glucose level may be closely related to the amelioration of insulin-resistance in the liver, thereby augmenting glucose uptake and inhibiting gluconeogenesis in liver through the regulation of glucose metabolism-related enzymes. There is no significant improvement in insulin-resistance in the skeletal muscles during the experiment period. This result implies that the effect of DJB surgery on type 2 diabetes is related to the duration of therapy.
Keywords:Type 2 diabetes mellitus  Goto-Kakizaki rats  Duodenal-jejunal bypass surgery  Euglycemic-hyperinsulinemic clamp technique  Insulin resistance
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