Effects of laparoscopic Roux-en-Y gastric bypass on glucose-6 phosphate dehydrogenase activity in obese type 2 diabetics.
Effects of laparoscopic Roux-en-Y gastric bypass on glucose-6 phosphate dehydrogenase activity in obese type 2 diabetics.
复制标题
腹腔镜 Roux-en-Y 胃绕道手术对肥胖 2 型糖尿病患者葡萄糖-6 磷酸脱氢酶活性的影响。
DOI：
10.1007/s00464-011-1959-8
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Richards,WilliamO
中科院分区：
文献类型：
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作者：
Schneider,AndrewM;Rawat,Dhwajbahadur;Weinstein,LSteve;Gupte,SachinA;Richards,WilliamO
背景葡萄糖-6-磷酸脱氢酶（G6 PD）是戊糖磷酸途径的限速酶，提供脂质生物合成所需的大部分NADPH。G6 PD过表达与动物的胰岛素抵抗、高脂血症和氧化应激增加有关。本研究检测了腹腔镜Roux-en-Y胃旁路术（LRYGB）前后肥胖糖尿病和非糖尿病受试者中G6 PD的表达。接受LRYGB的患者被招募用于IRB批准的研究，并被置于糖尿病组（n= 11）或非糖尿病组（n= 16）（糖尿病组，HbA 1c> 6.5%;非糖尿病组，HbA 1c < 6.0%）。在基线和术后前3个月采集血样。在手术过程中采集肝脏、脂肪和网膜样本。结果表示为平均值± SEM，并进行统计学比较，使用Mann-Whitney test.ResultsThe两组在基线时没有显着差异，除了空腹血糖和HbA 1c。与非糖尿病患者相比，糖尿病患者红细胞（RBC）（3.12 ± 1.39 vs. 0.67 ± 0.14）和肝脏（17.23 ± 2.40 vs. 9.74 ± 2.18）中的G6 PD活性（nm/min/mg蛋白）显著较高。肝脏G6 PD活性升高与HbA 1c（r2= 0.525）和空腹血糖（r2= 0.542）测量的糖尿病严重程度之间存在良好的相关性。脂肪和网膜G6 PD表达无显著差异。这两组经历了显着增加G6 PD血液活性后不久手术（1周），随后减少3个月后surgery.ConclusionThese结果是第一次看到在人类受试者，并证明增加G6 PD活性的糖尿病患者相比，nondiabetes。这些结果表明G6 PD活性与2型糖尿病的严重程度之间存在相关性。LRYGB后G6 PD活性的早期增加是出乎意料的，需要更长时间的随访来确定LRYGB对G6 PD活性的影响。
BackgroundGlucose-6-phosphate dehydrogenase (G6PD) is the rate-limiting enzyme of the pentose phosphate pathway that provides the majority of NADPH required for lipid biosynthesis. G6PD overexpression has been implicated in insulin resistance, hyperlipidemia, and increased oxidative stress in animals. This study examines G6PD expression in obese diabetic and nondiabetic subjects pre- and post-laparoscopic Roux-en-Y gastric bypass (LRYGB).MethodsPatients undergoing LRYGB were recruited for the IRB-approved study and placed in either the diabetic (n= 11) or nondiabetic group (n= 16) (diabetic, HbA1c > 6.5%; nondiabetic, HbA1c < 6.0%). Blood samples were collected at baseline and throughout the first 3 postoperative months. Liver, adipose, and omental samples were taken during surgery. Results are expressed as mean ± SEM and were compared statistically using the Mann–Whitney test.ResultsThe two groups were not significantly different at baseline except for fasting glucose and HbA1c. G6PD activity (nm/min/mg protein) was significantly higher in red blood cells (RBCs) (3.12 ± 1.39 vs. 0.67 ± 0.14) and liver (17.23 ± 2.40 vs. 9.74 ± 2.18) in diabetics compared to nondiabetics. There was good correlation between increased liver G6PD activity and the severity of diabetes as measured by HbA1c (r2= 0.525) and fasting glucose (r2= 0.542). No significant difference was found in the adipose or omental G6PD expression. Both groups experienced a significant increase in G6PD blood activity shortly following surgery (1 week) followed by a reduction 3 months after surgery.ConclusionThese results are the first ever seen in human subjects and demonstrate increased G6PD activity in diabetics compared to nondiabetics. These results suggest a correlation between G6PD activity and the severity of type 2 diabetes. The early increases in G6PD activity after LRYGB were unexpected and longer follow-up is needed to determine the effects of LRYGB on G6PD activity.