Bile Diversion in Roux-en-Y Gastric Bypass Modulates Sodium-Dependent Glucose Intestinal Uptake
Bile Diversion in Roux-en-Y Gastric Bypass Modulates Sodium-Dependent Glucose Intestinal Uptake
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DOI：
10.1016/j.cmet.2016.01.018
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发表时间：
2016-03-08
期刊：
影响因子：
29
通讯作者：
Pattou, Francois
中科院分区：
文献类型：
--
作者：
Baud, Gregory;Daoudi, Mehdi;Pattou, Francois
Roux-en-Y胃旁路（RYGB）排除胃肠道改善糖代谢，独立于体重减轻。虽然肠道胆汁运输的变化已被证明起作用，但其潜在机制尚不清楚。我们在小型猪身上进行了RYGB实验，结果表明，在无胆消化肢（AL）中，肠道对摄入的葡萄糖的吸收被削弱了。通过添加胆汁，AL中的葡萄糖摄取得以恢复，而当活性葡萄糖肠运输被苯二嗪阻断时，这种作用被消除。钠-葡萄糖共转运蛋白1在AL中仍有表达，而腔内钠含量明显降低。在AL中加入钠对葡萄糖摄取的影响与胆汁相同。它还增加了RYGB后清醒的小型猪的餐后血糖反应。在人体中证实了RYGB后肠道葡萄糖摄取的减少。我们的研究结果表明，胆汁分流通过调节钠-葡萄糖肠道共转运影响餐后葡萄糖代谢。
Gastro-intestinal exclusion by Roux-en-Y gastric bypass (RYGB) improves glucose metabolism, independent of weight loss. Although changes in intestinal bile trafficking have been shown to play a role, the underlying mechanisms are unclear. We performed RYGB in minipigs and showed that the intestinal uptake of ingested glucose is blunted in the bile-deprived alimentary limb (AL). Glucose uptake in the AL was restored by the addition of bile, and this effect was abolished when active glucose intestinal transport was blocked with phlorizin. Sodium-glucose cotransporter 1 remained expressed in the AL, while intraluminal sodium content was markedly decreased. Adding sodium to the AL had the same effect as bile on glucose uptake. It also increased postprandial blood glucose response in conscious minipigs following RYGB. The decrease in intestinal uptake of glucose after RYGB was confirmed in humans. Our results demonstrate that bile diversion affects postprandial glucose metabolism by modulating sodium-glucose intestinal cotransport.