• 川北醫(yī)學院附屬醫(yī)院普外一科(四川南充 637000);

目的  研究Roux-en-Y胃轉(zhuǎn)流術(shù)(RYGB)對2型糖尿病(T2DM)大鼠的治療作用,并探討內(nèi)臟脂肪組織產(chǎn)生的絲氨酸蛋白酶抑制劑(vaspin)在RYGB治療T2DM機制中的可能作用。
方法  取造模成功的T2DM大鼠20只和周齡、性別相匹配的正常SD大鼠20只,用隨機數(shù)字表法將其隨機分為T2DM-RYGB組、T2DM-假手術(shù)組及RYGB組、假手術(shù)組,每組10只。分別于術(shù)前及術(shù)后第4和8周檢測各組大鼠的空腹血糖(FPG)、血清胰島素(INS)、血清vaspin水平及胰島素抵抗指數(shù)(HOMA-IR),并分析血清vaspin水平與FPG、INS及HOMA-IR的相關(guān)性。
結(jié)果  手術(shù)前,T2DM-RYGB組與T2DM-假手術(shù)組比較以及RYGB組與假手術(shù)組比較,F(xiàn)PG水平、INS水平、vaspin水平及HOMA-IR差異均無統(tǒng)計學意義(P>0.05);而T2DM-RYGB組及T2DM-假手術(shù)組的FPG水平、INS水平、vaspin水平及HOMA-IR均分別明顯高于RYGB組(P<0.05)及假手術(shù)組(P<0.05)。術(shù)后第4周,T2DM-RYGB組FPG水平、INS水平、vaspin水平及HOMA-IR較術(shù)前下降,除FPG水平(P<0.05)外,其余指標與術(shù)前比較差異均無統(tǒng)計學意義(P>0.05);術(shù)后第8周,F(xiàn)PG水平、INS水平、vaspin水平及HOMA-IR進一步下降,與術(shù)前比較差異均有統(tǒng)計學意義(P<0.05)。T2DM-假手術(shù)組、RYGB組及假手術(shù)組組內(nèi)術(shù)前及術(shù)后第4周、第8周FPG水平、INS水平、vaspin水平及HOMA-IR比較,差異均無統(tǒng)計學意義(P>0.05)。手術(shù)前及手術(shù)后第4周、第8周T2DM-RYGB組與T2DM-假手術(shù)組血清vaspin水平與其對應血清INS水平、HOMA-IR均呈正相關(guān)(P<0.05)。
結(jié)論  RYGB對T2DM大鼠具有一定的治療作用,RYGB后vaspin表達水平降低,胰島素敏感性改善,這可能是RYGB治療T2DM的機制之一。

引用本文: 唐錦,魏壽江,王崇樹,李勛,何一,肖江衛(wèi). Roux-en-Y胃轉(zhuǎn)流術(shù)對2型糖尿病大鼠血清vaspin表達的影響△. 中國普外基礎與臨床雜志, 2012, 19(8): 823-827. doi: 復制

1. Klöting N, Berndt J, Kralisch S, et al. Vaspin gene expression in human adipose tissue:association with obesity and type 2 diabetes[J]. Biochem Biophys Res Commun, 2006, 339(1):430-436.
2. Youn BS, Klöting N, Kratzsch J, et al. Serum vaspin concentrations in human obesity and type 2 diabetes[J]. Diabetes,2008, 57(2):372-377.
3. Tan BK, Heutling D, Chen J, et al. Metformin decreases the adipokine vaspin in overweight women with polycystic ovary syndrome concomitant with improvement in insulin sensitivity and a decrease in insulin resistance[J]. Diabetes, 2008, 57(6):1501-1507.
4. Seeger J, Ziegelmeier M, Bachmann A, et al. Serum levels of the adipokine vaspin in relation to metabolic and renal parameters[J]. J Clin Endocrinol Metab, 2008, 93(1):247-251.
5. 司曉晨, 尚文斌, 卞慧敏, 等. 鏈脲佐菌素加高脂膳食誘導2型糖尿病大鼠模型[J]. 安徽中醫(yī)臨床雜志, 2003, 15(5):383-385.
6. Rubino F, Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes:a new perspective for an old disease[J]. Ann Surg, 2004, 239(1): 1-11.
7. 李光偉, 胡英華, 楊文英. 胰島素抵抗、胰島素分泌功能對Ⅱ型糖尿病發(fā)生的影響[J]. 中華內(nèi)科雜志, 1998, 37(9):600-604.
8. Frayn KN. Visceral fat and insulin resistancecausative or correlative?[J]. Br J Nutr, 2000, 83 Suppl 1:S71-S77.
9. Hida K, Wada J, Eguchi J, et al. Visceral adipose tissue-derived serine protease inhibitor:a unique insulin-sensitizing adipocytokine in obesity[J]. Proc Natl Acad Sci USA, 2005, 102(30):10610-10615.
10. Kempf K, Rose B, Illig T, et al. Vaspin (SERPINA12) genotypes and risk of type 2 diabetes:Results from the MONICA/KORA studies[J]. Exp Clin Endocrinol Diabetes, 2010, 118(3):184-189.
11. Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery:comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy:a prospective randomized trial[J]. Ann Surg, 2009, 250(2):234-241.
12. Laferrère B, Heshka S, Wang K, et al. Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes[J]. Diabetes Care, 2007, 30(7):1709-1716.
13. Meirelles K, Ahmed T, Culnan DM, et al. Mechanisms of glucose homeostasis after Roux-en-Y gastric bypass surgery in the obese, insulin-resistant Zucker rat[J]. Ann Surg, 2009, 249(2):277-285.
14. Gumbs AA, Modlin IM, Ballantyne GH. Changes in insulin resistance following bariatric surgery:role of caloric restriction and weight loss[J]. Obes Surg, 2005, 15(4):462-473.
15. Handisurya A, Riedl M, Vila G, et al. Serum vaspin concentrations in relation to insulin sensitivity following RYGB-induced weight loss[J]. Obes Surg, 2010, 20(2):198-203.
16. 王躍生, 史逸華, 陳福軍. 胃轉(zhuǎn)流術(shù)對2型糖尿病大鼠空腹血糖的影響及其機理[J]. 中國普外基礎與臨床雜志, 2011, 18(8):849-853.
17. 鄧治洲, 王烈, 林憶陽, 等. 胃轉(zhuǎn)流術(shù)對非肥胖型2型糖尿病的療效觀察及其對胰高血糖素樣肽-1的影響[J]. 中國普外基礎與臨床雜志, 2009, 16(6):466-469.
  1. 1. Klöting N, Berndt J, Kralisch S, et al. Vaspin gene expression in human adipose tissue:association with obesity and type 2 diabetes[J]. Biochem Biophys Res Commun, 2006, 339(1):430-436.
  2. 2. Youn BS, Klöting N, Kratzsch J, et al. Serum vaspin concentrations in human obesity and type 2 diabetes[J]. Diabetes,2008, 57(2):372-377.
  3. 3. Tan BK, Heutling D, Chen J, et al. Metformin decreases the adipokine vaspin in overweight women with polycystic ovary syndrome concomitant with improvement in insulin sensitivity and a decrease in insulin resistance[J]. Diabetes, 2008, 57(6):1501-1507.
  4. 4. Seeger J, Ziegelmeier M, Bachmann A, et al. Serum levels of the adipokine vaspin in relation to metabolic and renal parameters[J]. J Clin Endocrinol Metab, 2008, 93(1):247-251.
  5. 5. 司曉晨, 尚文斌, 卞慧敏, 等. 鏈脲佐菌素加高脂膳食誘導2型糖尿病大鼠模型[J]. 安徽中醫(yī)臨床雜志, 2003, 15(5):383-385.
  6. 6. Rubino F, Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes:a new perspective for an old disease[J]. Ann Surg, 2004, 239(1): 1-11.
  7. 7. 李光偉, 胡英華, 楊文英. 胰島素抵抗、胰島素分泌功能對Ⅱ型糖尿病發(fā)生的影響[J]. 中華內(nèi)科雜志, 1998, 37(9):600-604.
  8. 8. Frayn KN. Visceral fat and insulin resistancecausative or correlative?[J]. Br J Nutr, 2000, 83 Suppl 1:S71-S77.
  9. 9. Hida K, Wada J, Eguchi J, et al. Visceral adipose tissue-derived serine protease inhibitor:a unique insulin-sensitizing adipocytokine in obesity[J]. Proc Natl Acad Sci USA, 2005, 102(30):10610-10615.
  10. 10. Kempf K, Rose B, Illig T, et al. Vaspin (SERPINA12) genotypes and risk of type 2 diabetes:Results from the MONICA/KORA studies[J]. Exp Clin Endocrinol Diabetes, 2010, 118(3):184-189.
  11. 11. Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery:comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy:a prospective randomized trial[J]. Ann Surg, 2009, 250(2):234-241.
  12. 12. Laferrère B, Heshka S, Wang K, et al. Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes[J]. Diabetes Care, 2007, 30(7):1709-1716.
  13. 13. Meirelles K, Ahmed T, Culnan DM, et al. Mechanisms of glucose homeostasis after Roux-en-Y gastric bypass surgery in the obese, insulin-resistant Zucker rat[J]. Ann Surg, 2009, 249(2):277-285.
  14. 14. Gumbs AA, Modlin IM, Ballantyne GH. Changes in insulin resistance following bariatric surgery:role of caloric restriction and weight loss[J]. Obes Surg, 2005, 15(4):462-473.
  15. 15. Handisurya A, Riedl M, Vila G, et al. Serum vaspin concentrations in relation to insulin sensitivity following RYGB-induced weight loss[J]. Obes Surg, 2010, 20(2):198-203.
  16. 16. 王躍生, 史逸華, 陳福軍. 胃轉(zhuǎn)流術(shù)對2型糖尿病大鼠空腹血糖的影響及其機理[J]. 中國普外基礎與臨床雜志, 2011, 18(8):849-853.
  17. 17. 鄧治洲, 王烈, 林憶陽, 等. 胃轉(zhuǎn)流術(shù)對非肥胖型2型糖尿病的療效觀察及其對胰高血糖素樣肽-1的影響[J]. 中國普外基礎與臨床雜志, 2009, 16(6):466-469.