袖带胃切除术后胃泌素对葡萄糖耐量、肠道激素、食欲和食物摄入量的影响。

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Nora Hedbäck, Marie-Louise Dichman, Morten Hindsø, Carsten Dirksen, Nils Brun Jørgensen, Kirstine Nyvold Bojsen-Møller, Viggo B Kristiansen, Jens F Rehfeld, Bolette Hartmann, Jens Juul Holst, Maria Saur Svane, Sten Madsbad
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引用次数: 0

摘要

胃泌素是一种刺激食欲的激素,在空腹状态下由胃黏膜分泌,摄入食物后分泌减少。袖带胃切除术(SG)后,胃泌素的血浆浓度明显下降。这是否会影响术后食欲和葡萄糖耐量尚不清楚。我们研究了在袖带胃切除术前和术后三个月输注胃泌素对肥胖症患者食欲和糖耐量的影响。我们纳入了 12 名计划接受 SG 的患者。手术前和手术后三个月,在进行混合餐测试和自由餐测试后,同时输注酰基胃泌素(1 pmol/kg/min)或安慰剂。输注开始于进餐前 60 分钟,以便在混合餐前达到稳定状态,并持续整个研究日。在手术三个月后的另外两个实验日,分别输注了 0.25 pmol/kg/min 和 10 pmol/kg/min 的酰化格列林。与安慰剂相比,在注射胃泌素前后,餐后血糖浓度均呈剂量依赖性增加。注射胃泌素抑制了基础和餐后胰岛素分泌率,导致β细胞功能降低,但对胰岛素敏感性没有影响。施用胃泌素不会影响自由进餐。输注胃泌素会增加餐后血浆葡萄糖浓度,并在SG前后损害β细胞功能,但对自由进餐量没有影响。胃泌素注射后血糖控制得到改善,部分原因可能是胃泌素注射后的浓度永久性降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of ghrelin on glucose tolerance, gut hormones, appetite, and food intake after sleeve gastrectomy.

Ghrelin is an appetite-stimulating hormone secreted from the gastric mucosa in the fasting state, and secretion decreases in response to food intake. After sleeve gastrectomy (SG), plasma concentrations of ghrelin decrease markedly. Whether this affects appetite and glucose tolerance postoperatively is unknown. We investigated the effects of ghrelin infusion on appetite and glucose tolerance in individuals with obesity before and 3 mo after SG. Twelve participants scheduled for SG were included. Before and 3 mo after surgery, a mixed-meal test followed by an ad libitum meal test was performed with concomitant infusions of acyl-ghrelin (1 pmol/kg/min) or placebo. Infusions began 60 min before meal intake to reach a steady state before the mixed-meal and were continued throughout the study day. Two additional experimental days with 0.25 pmol/kg/min and 10 pmol/kg/min of acyl-ghrelin infusions were conducted 3 mo after surgery. Both before and after SG, postprandial glucose concentrations increased dose dependently during ghrelin infusions compared with placebo. Ghrelin infusions inhibited basal and postprandial insulin secretion rates, resulting in lowered measures of β-cell function, but no effect on insulin sensitivity was seen. Ad libitum meal intake was unaffected by the administration of ghrelin. In conclusion, ghrelin infusion increases postprandial plasma glucose concentrations and impairs β-cell function before and after SG but has no effect on ad libitum meal intake. We speculate that the lower concentration of ghrelin after SG may impact glucose metabolism following this procedure.NEW & NOTEWORTHY Ghrelin's effect on glucose tolerance and food intake following sleeve gastrectomy (SG) was evaluated. Acyl-ghrelin was infused during a mixed-meal and ad libitum meals before and 3 mo after surgery. Postprandial glucose concentrations increased during ghrelin infusions, both before and after surgery, while insulin production was inhibited. However, ad libitum meal intake did not differ during ghrelin administration compared with placebo. The decreased ghrelin concentration following SG may contribute to the glycemic control after surgery.

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来源期刊
CiteScore
9.80
自引率
0.00%
发文量
98
审稿时长
1 months
期刊介绍: The American Journal of Physiology-Endocrinology and Metabolism publishes original, mechanistic studies on the physiology of endocrine and metabolic systems. Physiological, cellular, and molecular studies in whole animals or humans will be considered. Specific themes include, but are not limited to, mechanisms of hormone and growth factor action; hormonal and nutritional regulation of metabolism, inflammation, microbiome and energy balance; integrative organ cross talk; paracrine and autocrine control of endocrine cells; function and activation of hormone receptors; endocrine or metabolic control of channels, transporters, and membrane function; temporal analysis of hormone secretion and metabolism; and mathematical/kinetic modeling of metabolism. Novel molecular, immunological, or biophysical studies of hormone action are also welcome.
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