Roux-en-Y胃旁路术缓解2型糖尿病GK大鼠肝脏胰岛素抵抗的机制

 目的研究Roux-en-Y胃旁路术（RYGB）后GK大鼠肝脏胰岛素抵抗缓解的机制。方法10只GK大鼠行RYGB（RYGB组），10只GK大鼠（GK组）和10只Wistar大鼠（WIS组）行假手术，检测RYGB手术前后大鼠体质量、空腹血糖、胰岛素抵抗指数的变化，检测手术前后大鼠血浆脂联素、肝细胞脂联素受体2、肝细胞内腺苷酸活化蛋白激酶（AMPK）、胰岛素受体底物2（IRS-2）的变化。结果 术前RYGB组与GK组大鼠存在明显的胰岛素抵抗， RYGB组术后血糖、胰岛素抵抗指数（HOMA-IR）基本恢复至正常水平，血浆脂联素水平升高。与WIS组比较，RYGB组大鼠肝细胞的AMPKα2 mRNA水平上调1.81倍（P＜0.05），IRS-2 mRNA水平上调3.24倍（P＜0.05）。结论RYGB后脂联素升高，通过脂联素受体作用于AMPK信号通路，增加葡萄糖利用，减少肝糖原异生，并通过上调IRS-2，达到缓解胰岛素抵抗的作用。

Gastric Bypass Surgery Ameliorates Insulin Resistance in the Liver of Goto-Kakizaki Rats

Objective To explore the mechanism of gastric bypass surgery ameliorating insulin resistance in the liver of GK rats.Methods Twenty GK rats were allocated into two groups in random,the RYGB group and GK group,and another ten Wistar rats in WIS group.RYGB operation was performed on RYGB group,and Sham operation on GK group and WIS group.Body weight,blood glucose,HOMA-IR,and plasma adiponectin were measured after operation,respectively.To disclose the effect of adiponectin,the expression of AdipoR2,IRS-2,AMPK were measured after operation,respectively.Results Blood glucose was normalized and serum insulin level was reduced in RYGB group.Plasma adiponectin concentration was elevated after the operation.AMPKα2 mRNA was up-regulated 1.81 fold(P < 0.05) and IRS-2 mRNA was up-regulated 3.24 fold(P < 0.05) in RYGB group and GK group,respectively.Conclusion RYGB can down regulate hyperglycemia and reverse insulin resistance in GK rats.Adiponectin can act on AdipoR2,IRS-2,AMPK and ameliorate insulin resistance after RYGB in the liver of GK rats.