胃转流术对2型糖尿病大鼠的降糖作用及对糖耐量和胰岛素抵抗的影响

目的 观察胃转流术(CBP)对2型糖尿病大鼠的降糖效果及对糖耐量和胰岛素抵抗的影响.方法 将健康雄性SD大鼠随机分为正常组(NO组,n=10)和造模组(n=32).成模大鼠随机分为糖尿病手术组(DO组)、假手术组(DS组)和对照组(DC组),每组8只.检测手术前后各组空腹血糖、胰岛素、口服葡萄糖30min后的血糖及胰岛素抵抗指数(HOMA-IR).检测DO组术前与术后第4周口服葡萄糖耐量实验后0、10、30、60、120、180 min血糖,计算糖耐量曲线下面积.结果DO组GBP术后第8周空腹血糖由术前的(17.80±2.26)mmol/L下降到(6.18±0.53)mmol/L(P<0.05),NO组手术前后空腹血糖无明显变化.口服葡萄糖30 min后血糖DO组下降更为明显,由术前的(29.20±1.46)mmol/L至术后第8周下降到(13.55±0.86)mmol/L(P<0.05).术后4周DO组各时间点OGTT曲线下面积(AUC)下降约40.1%.DO组术后8周HOMA-IR明显下降,由术前的9.36±0.90下降至4.03±0.34(P<0.05).结论 胃转流术能明显降低2型糖尿病大鼠的血糖水平,且能明显改善糖耐量和胰岛素抵抗,并对正常血糖值无影响.

Hypoglycemic effect and influence on glucose tolerance and insulin resistance of gastric bypass operation on type 2 diabetes mellitus rats

Objective To observe the hypoglycemic effect and influence on glucose tolerance and insulin resistance of gastric bypass operation (GBP) on type 2 diabetes mellitus rats.Methods Healthy male SD rats were randomly divided into normal rats group ( n = 10) and model group ( n = 32 ).The type 2 diabetes mellitus rats model were randomly divided into three groups: type 2 diabetes-operation group ( DO group),type 2 diabetes-shame operation group ( DS group ) and type 2 diabetes-control group ( DC group); The normal rats group was normal-operation group ( NO group).There were 8 rats in each group.Plasma glucose concentration,insulin and homeostasis model of insulin resistance (HMOA-IR) were measured respectively at fasting condition and plasma glucose concentration was measured at post oral glucose 30 min condition in preoperation and postoperation.Blood glucose in DO group were measured at 0,10,30,60,120,180 min after oral glucose and areas under curves were calculated in preoperative and postoperative 4 weeks.Results The fasting blood glucose of DO group rats decreased from preoperative ( 17.80 ±2.26 ) mmol/L to (6.18 ± 0.53 ) mmol/L 8 weeks post operation ( P ＜ 0.05 ); while the fasting blood glucose of NO group had no significant changes; DO group decreased more obvious post oral glucose 30min condition,and the plasma glucose concentration declined from preoperative ( 29.20 ± 1.46 ) mmol/L to ( 13.55 ± 0.86) mmol/L 8 weeks post operation ( P ＜ 0.05 ).AUC of DO group had decreased by 40.1% 4 weeks post operation.Homeostasis model of insulin resistance(HOMA-IR) of DO group had declined dramaticly,from preoperative 9.36 ± 0.90 to 4.03 ± 0.34 8 weeks post operation ( P ＜ 0.05 ).Conclusion Gastric bypass operation has a good hypoglycemic effect on type 2 diabetes mellitus rats.Gastric bypass operation is effective for improving glucose tolerance and insulin resistance,and has not hypoglycemic effect on normal plasma glucose.