Vertical Sleeve Gastrectomy Improves Glucose and Lipid Metabolism and Delays Diabetes Onset in UCD-T2DM Rats
Vertical Sleeve Gastrectomy Improves Glucose and Lipid Metabolism and Delays Diabetes Onset in UCD-T2DM Rats
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DOI：
10.1210/en.2012-1131
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发表时间：
2012-08-01
期刊：
影响因子：
4.8
通讯作者：
Havel, Peter J.
中科院分区：
文献类型：
--
作者：
Cummings, Bethany P.;Bettaieb, Ahmed;Havel, Peter J.
垂直袖式胃切除术（VSG）作为一种低发病率的减肥手术而引起了人们的兴趣，它在减肥和治疗2型糖尿病方面是有效的。然而，VSG预防2型糖尿病发病的功效尚未被研究过。对2月龄的加州大学戴维斯分校2型糖尿病前期雄性大鼠进行VSG或假手术。假手术动物要么是假手术自由喂养（S-AL），要么是与vsg手术动物（S-WM）体重匹配。通过每周非空腹血糖测量来确定糖尿病的发病。在术后1个月和4个月进行口服葡萄糖耐量试验，在术后1.5个月进行间接量热测定。与S-AL和S-WM动物相比，VSG手术显著延缓了糖尿病的发生。vsg手术的动物比S-AL少吃23%，体重少20%。能量消耗在vsg操作的动物和对照组之间没有差异。口服糖耐量试验结果表明，与S-AL和S-WM相比，vsg手术动物的糖耐量和胰岛功能得到改善。营养刺激的胰高血糖素样肽(GLP)-1、GLP-2和肽YY在vsg手术的动物中更大。VSG手术导致空腹血浆胰岛素、胃饥饿素和脂质浓度降低，空腹血浆脂联素和胆汁酸浓度显著升高，与体重无关。循环胆汁酸浓度的增加是由于牛磺酸偶联胆汁酸的选择性增加。因此，在加州大学戴维斯分校的2型糖尿病大鼠中，VSG延缓了2型糖尿病的发病，与体重无关。这可能是由循环胆汁酸、脂联素和营养刺激的GLP-1分泌增加和循环胃饥饿素浓度降低介导的。（内分泌学153:3620-3632,2012）
Vertical sleeve gastrectomy (VSG) has gained interest as a low morbidity bariatric surgery, which is effective in producing weight loss and causing type 2 diabetes resolution. However, the efficacy of VSG to prevent the onset of type 2 diabetes has not been previously investigated. VSG or sham surgery was performed on 2-month-old prediabetic male University of California Davis-type 2 diabetes mellitus rats. Sham-operated animals were either sham-operated ad libitum fed (S-AL) or were weight-matched to VSG-operated animals (S-WM). Diabetes onset was determined by weekly nonfasting blood glucose measurements. Animals underwent oral glucose tolerance tests at 1 and 4 months after surgery and indirect calorimetry at 1.5 months after surgery. VSG surgery significantly delayed diabetes onset compared with both S-AL and S-WM animals. VSG-operated animals ate 23% less and weighed 20% less than S-AL. Energy expenditure did not differ between VSG-operated animals and controls. Results from the oral glucose tolerance tests demonstrate improved glucose tolerance and islet function in VSG-operated animals compared with S-AL and S-WM. Nutrient-stimulated glucagon-like peptide (GLP)-1, GLP-2, and peptide YY excursions were greater in VSG-operated animals. VSG surgery resulted in decreased fasting plasma insulin, ghrelin and lipid concentrations, and markedly higher fasting plasma adiponectin and bile acid concentrations, independent of body weight. Increases of circulating bile acid concentrations were due to selective increases of taurine-conjugated bile acids. Thus, VSG delays type 2 diabetes onset in the University of California Davis-type 2 diabetes mellitus rat, independent of body weight. This is potentially mediated by increases of circulating bile acids, adiponectin, and nutrient-stimulated GLP-1 secretion and decreased circulating ghrelin concentrations. (Endocrinology 153: 3620-3632, 2012)