胃肠转流术对糖尿病大鼠降糖作用及GLP-1,IGF-1水平的影响研究

目的探究胃肠转流术对对糖尿病大鼠大鼠的降糖作用及胰高血糖素样肽-1(GLP-1)和大鼠胰岛素样生长因子-1(IGF-1)水平的影响。方法选择60只SD大鼠,随机平均分为对照组、假手术组、十二指肠转流组和空肠组,将假手术组、十二指肠转流组和空肠组大鼠复制糖尿病模型,对十二指肠转流组和空肠组行胃肠转流术。分别于术前以及术后第1、3和8周检查各组大鼠血糖水平、胰岛素水平、血清GLP-1水平和血清IGF-1水平。结果(1)对照组和假手术组大鼠存活率为100.00%、假手术组大鼠存活率为100.00%、十二指肠转流组大鼠存活率为93.33%、存活率为86.67%；(2)术前假手术组、十二指肠转流组和空肠转流组的血糖和胰岛素水平没有显著性差异(P>0.05),但显著高于对照组(均P<0.05),术后第3和8周十二指肠转流组和空肠转流组的血糖和胰岛素水平显著性低于同时间点假手术组(均P<0.05),术后第3和8周十二指肠转流组的血糖水平显著性低于同时间点空肠转流组且显著性低于同组术前(均P<0.05)；(3)术前假手术组、十二指肠转流组和空肠转流组的GLP-1和IGF-1水平没有显著性差异(P>0.05),但显著高于对照组(均P<0.05)；术后第3和8周十二指肠转流组和空肠转流组的GLP-1和IGF-1水平显著性高于同时间点假手术组(均P<0.05)；术后第3和8周十二指肠转流组的GLP-1和IGF-1水平显著性高于同时间点空肠转流组(均P<0.05)。结论胃肠转流术可以有效的治疗糖尿病模型大鼠,且随着转流大鼠小肠长度的增加,治疗糖尿病的作用更加明显,治疗糖尿病的作用机制之一可能为胃肠转流术升高GLP-1和IGF-1的合成分泌。

Effects of gastrointestinal bypass on hypoglycemic effect and GLP-1 and IGF-1 levels in diabetic rats

Objective To explore the effects of gastrointestinal bypass on hypoglycemic effect and GLP-1 and IGF-1 levels in diabetic rats. Methods60 SD rats were randomly divided into control group, sham operation group, duodenal bypass group and jejunum group.The rats in the sham operation group, the duodenal bypass group and the jejunum group were duplicated as diabetic models.Gastrointestinal bypass was performed in the duodenal bypass group and jejunum group.Blood glucose level, insulin level, serum GLP-1 level and serum IGF-1 level were examined before and first, third and 8 weeks after operation respectively . Results (1)The survival rate of the rats in the control group and the sham operation group was 100%, the survival rate of the sham operation group was 100%, the survival rate of the rats in the duodenal bypass group was 93.33% and the survival rate was 86.67%.(2)There was no significant difference in blood glucose and insulin levels between the pre operation group, the duodenal bypass group and the jejunum bypass group (P>0.05), but significantly higher than the control group (P<0.05). The blood glucose and insulin levels in the duodenal bypass group and the jejunum bypass group were significantly lower than those in the same time sham operation group (P<0.05, all P<0.05). Third and eighth weeks after operation, the blood glucose level of the duodenal bypass group was significantly lower than that of the jejunal bypass group at the same time point, and significantly lower than that of the same group (P<0.05).(3) There was no significant difference in GLP-1 and IGF-1 levels between the preoperation sham operation group, the duodenal bypass group and the jejunum bypass group (P>0.05), but significantly higher than the control group (all P<0.05). The GLP-1 and IGF-1 levels of the duodenal bypass group and the jejunum bypass group were significantly higher than those in the same time sham operation group (all P<0.05) at third and eighth weeks after the operation. The levels of GLP-1 and IGF-1 in the duodenal bypass group were significantly higher than those in the jejunal bypass group at the same time point (P<0.05) after third and eighth weeks.Conclusions Gastrointestinal bypass can be effective in the treatment of diabetic rats, and with the increase of the length of the small intestine in the rat, the effect of the treatment of diabetes is more obvious. One of the mechanisms of action for the treatment of diabetes may be the synthesis and secretion of GLP-1 and IGF-1 by gastrointestinal bypass.