改变胃旁路术Roux肠袢长度对GK大鼠糖代谢改善的影响

目的研究胃旁路术(RYGB)中,不同Roux肠袢长度对GK大鼠糖代谢和激素分泌的影响。方法将GK大鼠随机分为5组,未处理组(GK-Blank)、假手术饮食对照组(GK-PF-Sham)和3组RYGB手术组。手术组根据Roux肠袢长度3 cm、12 cm和30cm分为GK-S-3 cm组、GK-S-12 cm组、GK-S-30 cm组,同时用Wistar大鼠作为正常对照。定期测量大鼠体质量;术后6个月,对各组大鼠行口服糖耐量试验、腹腔糖耐量试验和胰岛素耐量试验,并眼眶取血检测血中胰岛素及激素含量。结果 GK-S-12 cm组及GK-S-30 cm组大鼠体质量显著低于GK-Blank组,GK-S-3 cm组在各实验时间点均未观察到明显体质量下降。GK-S-30 cm组在胰岛素抵抗、口服和腹腔注射葡萄糖耐受性上,均显著优于GK-S-3 cm组与GK-Blank组。经葡萄糖灌胃,3个手术组胰岛素分泌、GLP-1水平都有明显改善,显著不同于GK-Blank组及GK-PF-Sham组。结论胃旁路手术中,通过构建不同的Roux肠袢长度,可不同程度缓解2型糖尿病病症。增加Roux袢长度,更有助于改善糖耐量,并提高胰岛素敏感性。

Variable ameliorated glycometabolism in GK rats by Roux-en-Y gastric bypass surgeries with different lengths of Roux limbs

Objective To study the effect of different lengths of Roux limb on glucose glycometabolism and hormones secretion of GK rats in gastric bypass surgeries.Methods GK rats were randomly divided into 5 groups：non-treated （GK-Blank）,Sham operated and pair-feed （GK-PF-Sham）,and three RYGB groups with Roux limb lengths 3 cm,12 cm and 30 cm （GK-S-3 cm,GK-S-12 cm,GK-S-30 cm groups,respectively）.Normal Wistar rats were used as nondiabetic controls.Body weights were measured periodically.Around 6 months post-operation,intraperitoneal glucose tolerance tests （IPGTTs）,oral glucose tolerance tests （OGTTs） and insulin tolerance tests （ITTs） of rats in every group were measured,and blood from the superior ophthalmic vein was also collected to measure insulin and hormone levels.Results Body weights of GK-S-12 cm and GK-S-30 cm groups were significantly lower than those of GK-Blank group; however,GK-S-3 cm group did not result in significant weight loss at all measured time points.Insulin and glucose tolerance showed significantly improved in GK-S-30 cm group,compared with GK-S-3 cm,GK-Blank and GK-PF-Sham groups.Glucose tolerance was also improved in the GK-S-12 cm group,compared with the GK-S-3 cm,GK-Blank and GK-PF-Sham groups,evidenced by the significantly lowered AUC.Glucose tolerance was not significantly different in the GK-S-3 cm group compared with GK-Blank and GK-PF-Sham groups.Insulin secretion after glucose stimulation and GLP-1 level showed improvement in all three surgical groups compared with GK-PF-Sham and GK-Blank groups.Conclusion Constructing different lengths of Roux limb in the RYGB surgeries can ameliorate T2DM symptoms with varying degrees.Increasing the length of Roux limb can improve sugar tolerance and increase the sensitivity of insulin.