胃旁路术及迷走神经肝支对2型糖尿病大鼠降糖效果的影响

目 的 观察Roux-en-Y胃旁路术(RYGB) 及迷走神经肝支对2型糖尿病大鼠降糖效果及空腹血清胰高血糖素样肽-1(GLP-1)的影响及交互作用。方法 将45只2型糖尿病大鼠分成假手术组(S组)；假手术 迷走神经肝支切断组(SV组)；手术组(RYGB组)；手术组 迷走神经肝支切断组(RYGBV组)。检测术前及术后体质量、空腹血糖、空腹血浆胰岛素水平、空腹血清GLP-1浓度,分析RYGB和迷走神经肝支对空腹血清GLP-1的影响。结 果 RYGB 组的2型糖尿病大鼠体质量明显下降(P<0.05), 提高空腹血清GLP-1和胰岛素水平 (P<0.05), 同时降低空腹血糖水平 (P<0.05). 保留迷走神经肝支,能长期维持较低体重 (P<0.05), 提高空腹血清GLP-1和胰岛素水平(P<0.05), 对空腹血糖无影响(P>0.05).。结 论Roux-en-Y胃旁路术对2型糖尿病具有较好的治疗效果,RYGB术中应当注意保护迷走神经肝支。

Impact of gastric bypass treatment and hepatic branch of the vagus on hypoglycemic outcome in rats with type 2 diabetes

Objective The impact of Roux-en-Y gastric bypass (RYGB) treatment and hepatic branch of vagus on hypoglycemic effect and glucagon-like peptide-1(GLP-1) in rats with type 2 diabetes (T2DM) is investigated, and interaction is also preliminarily analyzed. Methods 45 type 2 diabetic rats were divided into four groups: sham operation (S), sham operation with the hepatic branch of the vagus resected (SV), Roux-en-Y gastric bypass (RYGB), and RYGB without preservation of the vagus (RYGBV).The body mass, fasting blood-glucose (FBG), fasting serum insulin (FINS) and concentrations of fasting serum GLP-1 were examined before and after surgery. Effect of RYGB and the hepatic branch of vagus to GLP-1 levels were also analyzed. Results RYGB may cause a significant reduction in weight of rats with type 2 diabetes (P<0.05), improve both the levels of serum GLP-1 and insulin (P<0.05), while decrease the FBG level (P<0.05). The retention of the hepatic branch of vagus can either maintain the lower weight for a long term (P<0.05), or increase both the levels of serum GLP-1 and insulin (P<0.05), imposing no impact on FBG (P>0.05). Conclusion Roux-en-Y Gastric Bypass Treatment can produce better therapeutic efficacy to the type 2 diabetes. Care shall be taken during RYGB surgery to preserve the hepatic branch of vagus.