肥胖患者胃粘膜神经支配减少:一个预测减肥手术后糖尿病缓解的生物标志物。

Po-Jen Yang, Ping-Huei Tseng, Koping Chang, Chi-Chao Chao, Jing-Jung Wei, Wei-Shiung Yang, Chi-Ling Chen, Hui-Fang Ke, Po-Chu Lee, Chiung-Nien Chen, Ming-Tsan Lin, Sung-Tsang Hsieh
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摘要

目的:肥胖是胃功能失调和周围神经变性的危险因素。本研究旨在探讨肥胖对胃黏膜神经支配结构病理学和形态学的影响。方法:选取60例接受2型糖尿病套筒胃切除术的肥胖患者(30例合并2型糖尿病,30例不合并2型糖尿病)和15例健康对照。采用蛋白基因产物9.5对胃窦处的胃粘膜神经末梢进行免疫染色,并用基于体视学的形态计量学定量测定胃粘膜神经支配密度(GMID)。结果:肥胖患者ggmd低于对照组(464.0±157.5 vs 789.7±188.9 mm/mm3, p = 3, p3 vs 341.1±88.1 mm/mm3, p = 0.012)。在多变量logistic回归分析中,GMID仍然是糖尿病缓解的独立预测因子。结论:肥胖和糖尿病的协同作用显著降低了胃粘膜神经支配。GMID可以作为预测减肥手术后糖尿病缓解的潜在生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reduced Gastric Mucosal Innervation in Obesity: A Biomarker Predicting Remission of Diabetes After Bariatric Surgery.

Objective: Obesity is a risk factor for dysregulated gastric function and peripheral nerve degeneration. This study aimed to investigate the impact of obesity on the structural pathology and morphometry of gastric mucosal innervation.

Methods: Sixty patients with obesity (30 with and 30 without type 2 diabetes) undergoing sleeve gastrectomy and 15 healthy controls were recruited. Gastric mucosal nerve terminals at the antrum were immunostained using protein gene product 9.5 and quantified using stereology-based morphometry to determine gastric mucosal innervation density (GMID).

Results: Patients with obesity had lower GMID than control participants (464.0 ± 157.5 vs. 789.7 ± 188.9 mm/mm3, p < 0.001). There was a further reduction in GMID in patients with diabetes than in those without diabetes (406.8 ± 113.9 vs. 521.2 ± 175.3 mm/mm3, p < 0.001). GMID was significantly associated with BMI and glycemic parameters (fasting blood glucose, HbA1c) in multilinear regression analyses. One year post surgery, 19 patients achieving diabetes remission showed higher GMID compared to those without remission (444.8 ± 111.5 mm/mm3 vs. 341.1 ± 88.1 mm/mm3, p = 0.012). GMID remained an independent predictor for diabetes remission in multivariable logistic regression analyses.

Conclusions: Gastric mucosal innervation was significantly reduced by the synergistic effects of obesity and diabetes. GMID could serve as a potential biomarker for predicting diabetes remission following bariatric surgery.

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