Physiological and molecular responses to bariatric surgery: markers or mechanisms underlying T2DM resolution?
Physiological and molecular responses to bariatric surgery: markers or mechanisms underlying T2DM resolution?
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减肥手术的生理和分子反应：T2DM 消退的标志物或机制？
DOI：
10.1111/nyas.13194
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发表时间：
2017
影响因子：
5.2
通讯作者：
Sandoval,DarleenA
中科院分区：
文献类型：
--
作者：
Hutch,ChelseaR;Sandoval,DarleenA
减肥手术是目前治疗肥胖及相关合并症最有效的方法，包括快速解决2型糖尿病（T2DM）。虽然减肥本身有实质性的影响，但减肥手术对2型糖尿病也有独立于减肥的效果。目前存在几种不同的减肥手术，包括广泛研究的Roux - en - Y胃旁路手术和垂直套管胃切除术。这两种减肥手术的成功最初归因于限制性和吸收不良的作用模式；然而，来自人类和动物研究的越来越多的证据表明，手术引起的胃肠道（GI）系统机械变化之外的机制。事实上，减肥手术带来了一系列的生理反应，包括餐后肠道肽和胆汁酸水平的提高，微生物组成的重组，以及胃肠道功能和形态的变化。虽然这些过程中的许多对血糖调节也是必不可少的，但每个过程在手术成功中的独立作用仍然是一个悬而未决的问题。在这篇综述中，我们探讨这些变化是否对改善体重和葡萄糖稳态是必要的，或者它们是否仅仅是手术生理效应的标志。
Bariatric surgery is currently the most effective treatment for obesity and associated comorbidities, including rapid resolution of type 2 diabetes mellitus (T2DM). Although the weight loss itself has substantial impact, bariatric surgery also has weight loss–independent effects on T2DM. Several variations of bariatric surgery exist, including the widely studied Roux‐en‐Y gastric bypass and vertical sleeve gastrectomy. The success of both of these bariatric surgeries was originally attributed to restrictive and malabsorptive modes of action; however, mounting evidence from both human and animal studies implicates mechanisms beyond surgery‐induced mechanical changes to the gastrointestinal (GI) system. In fact, with bariatric surgery comes a spectrum of physiological responses, including postprandial enhancement of gut peptide and bile acids levels, restructuring of microbial composition, and changes in GI function and morphology. Although many of these processes are also essential for glucoregulation, the independent role of each in the success of surgery is still an open question. In this review, we explore whether these changes are necessary for the improvements in body mass and glucose homeostasis or whether they are simply markers of the physiological effect of surgery.
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