Bariatric Surgery: Prevalence, Predictors, and Mechanisms of Diabetes Remission
Bariatric Surgery: Prevalence, Predictors, and Mechanisms of Diabetes Remission
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DOI：
10.1007/s11892-015-0590-9
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发表时间：
2015-04-01
影响因子：
4.2
通讯作者：
Argyropoulos, George
中科院分区：
文献类型：
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作者：
Argyropoulos, George
2 型糖尿病是一种慢性疾病，可以通过药物和/或生活方式干预来治疗，但在大多数情况下无法治愈。然而，可以缓解糖尿病的少数干预措施之一是 Roux-en-Y 胃绕道手术 (RYGB) 手术。大约 63% 接受 RYGB 手术的患者的糖尿病得到缓解，但其潜在机制尚不清楚。一些研究表明肠肝通路的主要成分是胆汁酸、成纤维细胞生长因子 19 (FGF19) 和胰高血糖素样肽 1 (GLP-1)。在这里，我们讨论这些肠肝变化并强调胆汁酸、FGF19 和 GLP-1 在糖尿病缓解中的作用。我们还描述了现在如何在手术前使用 DiaRem 评分实际预测 RYGB 手术后糖尿病缓解的概率。更深入地了解 RYGB 手术缓解糖尿病的机制可以为开发更有效的干预措施来治愈该疾病提供基础。
Type 2 diabetes is a chronic disease that can be treated with pharmacologic and/or lifestyle interventions, but in most cases it does not get cured. One of the few interventions, however, that can remit diabetes is the Roux-en-Y gastric bypass (RYGB) surgery. Approximately 63 % of patients undergoing RYGB surgery experience diabetes remission, but the underlying mechanisms are poorly understood. Some studies implicate enterohepatic pathways with bile acids, fibroblast growth factor 19 (FGF19), and glucagon-like peptide 1 (GLP-1) being the primary components. Here, we discuss these enterohepatic changes and highlight the roles of bile acids, FGF19, and GLP-1 in diabetes remission. We also describe how we can now actually predict, prior to surgery, the probability for remitting diabetes after RYGB surgery by using the DiaRem score. Deeper understanding of the mechanisms of diabetes remission by RYGB surgery could provide the basis for developing more effective interventions for curing the disease.