{"title":"The effects of sleeve gastrectomy on hormonal regulation of glucose metabolism in Goto-Kakizaki rats.","authors":"Z Zhu, X Yang, K Wang, Z Wang, Y Zhao, M Yu","doi":"10.1007/s10353-014-0270-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The antidiabetic effect of sleeve gastrectomy (SG) has been interpreted as a conceivable result of surgically induced weight loss in the obese type 2 diabetes mellitus (T2DM) subjects. However, the blood glucose control often occurs within days, before significant weight loss has been reached. This work aims to investigate the major mechanism and persistence regarding how SG improves glucose metabolism in nonobese T2DM rats.</p><p><strong>Methods: </strong>These Goto Kakizaki rats (<i>n</i> = 21) were randomly assigned into three groups: SG, sham SG, and pair-fed (PF) group, whose weight, food intake, oral glucose tolerance test, insulin tolerance test, plasma insulin, homeostasis model assessment for insulin resistance (HOMA-IR), ghrelin, and glucagon-like peptide-1 (GLP-1) were measured.</p><p><strong>Results: </strong>According to the experiment, from the 2nd week until the 24th week, the fasting blood glucose of the rats in the SG group had significantly decreased with the improved glucose tolerance. At the 2nd week postoperation, the area under the blood glucose concentration curve (AUC) received a distinct reduction of 28.1 % (<i>P</i> < 0.0001). The ghrelin secretion of the SG group was significantly decreased (<i>P</i> < 0.005). The GLP-1 had increased (<i>P</i> < 0.0001), while the HOMA-IR values decreased (<i>P</i> < 0.05) throughout the experimental period. These effects were not seen in the sham-SG and PF groups despite similar changes of weight loss or food intake.</p><p><strong>Conclusions: </strong>The above results suggest that SG can conduct a direct control on T2DM instead of secondarily to weight loss or food intake around the whole experimental period. The changes of the gastrointestinal hormones may be the major mechanism of the antidiabetic effect.</p>","PeriodicalId":50475,"journal":{"name":"European Surgery-Acta Chirurgica Austriaca","volume":null,"pages":null},"PeriodicalIF":0.6000,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10353-014-0270-z","citationCount":"6","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Surgery-Acta Chirurgica Austriaca","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10353-014-0270-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/7/10 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 6
Abstract
Background: The antidiabetic effect of sleeve gastrectomy (SG) has been interpreted as a conceivable result of surgically induced weight loss in the obese type 2 diabetes mellitus (T2DM) subjects. However, the blood glucose control often occurs within days, before significant weight loss has been reached. This work aims to investigate the major mechanism and persistence regarding how SG improves glucose metabolism in nonobese T2DM rats.
Methods: These Goto Kakizaki rats (n = 21) were randomly assigned into three groups: SG, sham SG, and pair-fed (PF) group, whose weight, food intake, oral glucose tolerance test, insulin tolerance test, plasma insulin, homeostasis model assessment for insulin resistance (HOMA-IR), ghrelin, and glucagon-like peptide-1 (GLP-1) were measured.
Results: According to the experiment, from the 2nd week until the 24th week, the fasting blood glucose of the rats in the SG group had significantly decreased with the improved glucose tolerance. At the 2nd week postoperation, the area under the blood glucose concentration curve (AUC) received a distinct reduction of 28.1 % (P < 0.0001). The ghrelin secretion of the SG group was significantly decreased (P < 0.005). The GLP-1 had increased (P < 0.0001), while the HOMA-IR values decreased (P < 0.05) throughout the experimental period. These effects were not seen in the sham-SG and PF groups despite similar changes of weight loss or food intake.
Conclusions: The above results suggest that SG can conduct a direct control on T2DM instead of secondarily to weight loss or food intake around the whole experimental period. The changes of the gastrointestinal hormones may be the major mechanism of the antidiabetic effect.
背景:在肥胖的2型糖尿病(T2DM)患者中，袖胃切除术(SG)的降糖作用被解释为手术诱导体重减轻的可能结果。然而，血糖控制通常发生在体重明显减轻之前的几天内。本研究旨在探讨SG改善非肥胖T2DM大鼠糖代谢的主要机制和持久性。方法:将21只Goto Kakizaki大鼠随机分为SG组、假SG组和配对喂养组(PF组)，测定其体重、摄食量、口服糖耐量、胰岛素耐量、血浆胰岛素、胰岛素抵抗稳态模型评估(HOMA-IR)、生长素(ghrelin)、胰高血糖素样肽-1 (GLP-1)水平。结果:实验显示，从第2周到第24周，SG组大鼠空腹血糖明显降低，糖耐量提高。术后第2周，血糖浓度曲线下面积(AUC)明显降低28.1% (P P P P P)。结论:在整个实验期间，SG可直接控制T2DM，而不是继发于减肥或进食。胃肠激素的改变可能是其降糖作用的主要机制。
期刊介绍：
The journal European Surgery – Acta Chirurgica Austriaca focuses on general surgery, endocrine surgery, thoracic surgery, heart and vascular surgery. Special features include new surgical and endoscopic techniques such as minimally invasive surgery, robot surgery, and advances in surgery-related biotechnology and surgical oncology.
The journal especially addresses benign and malignant esophageal diseases, i.e. achalasia, gastroesophageal reflux disease, Barrett’s esophagus, and esophageal adenocarcinoma. In keeping with modern healthcare requirements, the journal’s scope includes inter- and multidisciplinary disease management (diagnosis, therapy and surveillance).
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