Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy
Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy
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DOI：
10.1152/ajpendo.00469.2013
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发表时间：
2014-02-01
影响因子：
5.1
通讯作者：
Sandoval, Darleen A.
中科院分区：
文献类型：
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作者：
Chambers, Adam P.;Smith, Eric P.;Sandoval, Darleen A.
Roux-en-Y胃旁路术（RYGB）和垂直袖状胃切除术（VSG）是有效的减肥手术，也可以改善葡萄糖代谢。这些程序的特征是食物摄入后循环胰岛素和胰高血糖素样肽-1（GLP-1）浓度的快速早期升高。本研究的目的是检验这一假设，即餐后激素的释放是由于增加营养从胃排空。应用放射闪烁显像、化学示踪剂和放射性示踪剂对VSG和RYGB手术大鼠模型的胃排空进行了检测。采用十二指肠内营养输注评估VSG大鼠与假手术大鼠相比的肠道GLP- 1分泌和营养敏感性。营养灌胃后5分钟，RYGB和VSG大鼠的胃完全排空，而假手术动物的营养混合物仅排空6.1%。VSG动物的胃压增加，并且采用该程序的大鼠在葡萄糖或玉米油的热量负荷增加时不会抑制胃排空，并且它们对胃运动的神经或内分泌效应物没有反应。最后，与假手术相比，将液体营养物直接输注到十二指肠中导致VSG中显著更大的GLP-1释放，表明VSG后GLP-1分泌增加是胃排空率更高和肠道水平反应改变的结果。这些发现表明在RYGB和VSG大鼠模型中胃排空大大加速。在VSG中，这可能是由于胃压增加和对来自肠的抑制性反馈的反应降低。
Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) are effective weight loss surgeries that also improve glucose metabolism. Rapid, early rises of circulating insulin and glucagon-like peptide-1 (GLP-1) concentrations following food ingestion are characteristic of these procedures. The purpose of the current study was to test the hypothesis that postprandial hormone release is due to increased nutrient emptying from the stomach. Radioscintigraphy and chemical and radiolabeled tracers were used to examine gastric emptying in rat models of VSG and RYGB surgery. Intraduodenal nutrient infusions were used to assess intestinal GLP- 1 secretion and nutrient sensitivity in VSG rats compared with shams. Five minutes after a nutrient gavage, the stomachs of RYGB and VSG rats were completely emptied, whereas only 6.1% of the nutrient mixture had emptied from sham animals. Gastric pressure was increased in VSG animals, and rats with this procedure did not inhibit gastric emptying normally in response to increasing caloric loads of dextrose or corn oil, and they did not respond to neural or endocrine effectors of gastric motility. Finally, direct infusion of liquid nutrients into the duodenum caused significantly greater GLP-1 release in VSG compared with shams, indicating that increases in GLP-1 secretion after VSG are the result of both greater gastric emptying rates and altered responses at the level of the intestine. These findings demonstrate greatly accelerated gastric emptying in rat models of RYGB and VSG. In VSG this is likely due to increased gastric pressure and reduced responses to inhibitory feedback from the intestine.