袖状胃切除附加改良空回肠旁路术对GK大鼠血糖和血脂代谢的影响

摘要

目的 探讨袖状胃切除附加改良空回肠旁路术对非肥胖2型糖尿病动物模型(GK大鼠)血糖和血脂代谢的影响.方法 随机将 21只GK大鼠分为袖状胃切除附加改良空回肠旁路术(SG/MJIB)组9只、假手术(sham-SG/MJIB)组6只和饮食配对(PF)组6只.动态观察手术前和术后16周中各组大鼠体重、进食量、空腹血糖、葡萄糖耐量、胰岛素耐量、胰岛素和脂质浓度的变化.结果 自手术后第4周起,SG/MJIB组的体重增量明显低于sham-SG/MJIB组和PF组,差异有统计学意义(P＜0.01).SG/MJIB组空腹血糖较其它2组明显降低(P＜0.05);SG/MJIB组术后2周OGTT曲线下面积(AUC)较其术前减少约38.9%(P＜0.01),相对于其它2组差异有统计学意义(P＜0.05).与PF组和sham-SG/MJIB组相比,SG/MJIB组在术后的血脂浓度得到明显改善.结论 SG/MJIB可独立于体重和进食量的变化而直接有效地改善GK大鼠的血糖和血脂代谢.%Objective To investigate the effect of sleeve gastrectomy with modified jej unoileal bypass( SG/MJIB) on the me tabolism of blood glucose and blood lipids in the Goto-Kakizaki(GK) rats. Methods Twentyone GK rats were randomly divided into SG/MJIB group(n = 9) , sham-SG/MJIB group(n = 6) and pairfed(PF) group(n = 6). Before and after surgery during a duration of 16 weeks, the changes of weight gain , food intake , fasting glucose, oral glucose tolerance test( (OGTT) ,insulin tolerance test(ITT) , plasma insulin and lipid were observed. Results From the 4th postoperative week, the weight gain in SG/MJIB group was significantly decreased as compared with sham-SG/MJIB group and PF group(P＜0. 01). Fasting glucose concentra tion in SG/MJIB group was lower than in sham-SG/MJIB and PF groups(P＜0. 05). Two weeks after operation,glucose tolerance was improved in SG/MJIB group,and the area under the curve(AUC)of blood glucose concentration was decreased by about 38. 9 ％ (P＜0. 0l)as compared with those preoperation. These effects were not seen in sham-SG/MJIB and PF groups despite similar change of weight gain. Throughout the experiment period.the concentration of blood lipids in SG/MJIB group was obviously improved as compared with PF and sham-SG/MJIB groups. Conclusion SG/MJIB is directly and effectively linked to improve the metabolism of blood glucose and blood lipids in GK rats,independently of weight loss and caloric intake.