Sleeve Gastrectomy with Bypass of Proximal Small Intestine Provides Better Diabetes Control than Sleeve Gastrectomy Alone Under Postoperative High-Fat Diet
Sleeve Gastrectomy with Bypass of Proximal Small Intestine Provides Better Diabetes Control than Sleeve Gastrectomy Alone Under Postoperative High-Fat Diet
复制标题
袖状胃切除术联合近端小肠旁路术在术后高脂肪饮食下比单独袖状胃切除术能更好地控制糖尿病
DOI：
10.1007/s11695-018-3520-5
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发表时间：
2019-01-01
期刊：
影响因子：
2.9
通讯作者：
Liu, Shaozhuang
中科院分区：
文献类型：
--
作者：
Cheng, Yugang;Huang, Xin;Liu, Shaozhuang
背景袖状胃切除术（SG）加手术已被开发出来，以加强 SG 对糖尿病控制的效果。本研究的目的是比较 SG 加近端小肠旁路术与单独 SG 在糖尿病缓解不利条件下的糖尿病控制情况。 方法 对糖尿病大鼠进行 SG 加十二指肠空肠旁路术 (SG-DJB)、SG 加空肠空肠旁路术 (SG-JJB)、单独 SG 和假手术。术后饲喂高脂饮食（HFD）以诱导糖尿病复发。术后测量体重、摄食量、糖耐量、胰岛素敏感性、血清激素、肝功能和血脂谱。结果术后 2 周，SG-DJB、SG-JJB 和 SG 组与假手术组相比，糖耐量和胰岛素敏感性显着改善。术后 HFD 导致明显的糖尿病复发，并在术后 16 周再次损害胰岛素敏感性。术后 16 周，SG-DJB 和 SG-JJB 组表现出优于单独 SG 的葡萄糖耐量和相似的胰岛素敏感性。与单独的SG相比，SG-DJB和SG-JJB组表现出相似的食物摄入量、体重减轻、空腹生长素释放肽、葡萄糖刺激的胰岛素分泌和更高的葡萄糖刺激的GLP-1分泌。结论在术后饲喂HFD的大鼠中，SG-DJB和SG-JJB比单独的SG提供更好的糖尿病控制。预计进一步的临床研究将证实 SG 加近端小肠旁路术的优越性。
BackgroundSleeve gastrectomy (SG) plus procedures have been developed to strengthen the effect of SG on diabetes control. The aim of this study was to compare diabetes control after SG plus bypass of the proximal small intestine with SG alone under adverse conditions for diabetes remission.MethodsSG plus duodenojejunal bypass (SG-DJB), SG plus jejunojejunal bypass (SG-JJB), SG alone, and sham surgeries were performed in diabetic rats. A high-fat diet (HFD) was fed postoperatively to induce diabetes recurrence. Body weight, food intake, glucose tolerance, insulin sensitivity, serum hormones, hepatic function, and lipid profiles were measured postoperatively.ResultsSG-DJB, SG-JJB, and SG groups exhibited significant improvement in glucose tolerance and insulin sensitivity compared with the sham-operated group at 2 weeks postoperatively. Postoperative HFD induced obvious diabetes relapse and re-impaired insulin sensitivity at 16 weeks postoperatively. The SG-DJB and SG-JJB groups exhibited superior glucose tolerance and similar insulin sensitivity to SG alone at 16 weeks postoperatively. Compared with the SG alone, the SG-DJB and SG-JJB groups exhibited similar food intake, weight loss, fasting ghrelin, glucose-stimulated insulin secretion, and higher glucose-stimulated GLP-1 secretion.ConclusionSG-DJB and SG-JJB provided better diabetes control than SG alone in rats fed a HFD postoperatively. Further clinical studies are expected to confirm the superiority of SG plus bypass of proximal small intestine.