十二指肠空肠旁路术与十二指肠空肠吻合术对2型糖尿病大鼠视黄醇结合蛋白4的作用及意义
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江苏省科技厅基础研究计划(自然科学基金)(BK20131441)


The role of duodenal-jejunal anastomosi and duodenal-jejunal bypass on RBP-4 in rats with type 2 diabetes
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    摘要:

    目的:探讨十二指肠空肠旁路术(duodenal-jejunal bypass,DJB)与十二指肠空肠吻合术(duodenal-jejunal anastomosi,DJA)对2型糖尿病治疗效果的异同及视黄醇结合蛋白4(retinol binding protein-4,RBP-4)和葡萄糖转运蛋白4(glucose transporter-4,GLUT-4)在其中的作用。方法:糖尿病大鼠随机分为DJA组、DJB组和假手术组,测定其手术前后体重、摄食量、空腹血糖、空腹胰岛素、RBP-4水平,评估手术前后糖代谢情况及胰岛素抵抗情况,术后第8周测定GLUT-4水平。结果:与假手术组相比,DJA组和DJB组术后空腹血糖降低,OGTT葡萄糖曲线下面积减少,胰岛素抵抗有所改善,RBP-4水平下降,骨骼肌GLUT-4水平升高。结论:DJB和DJA手术能不依赖摄食量、体重及胰岛素分泌的增加而改善糖尿病大鼠糖代谢,缓解其胰岛素抵抗状态,两者对空腹血糖的改善作用相似,但DJA手术对餐后血糖调节作用较差,可能与术后RBP-4降低、GLUT-4升高幅度不同有关。

    Abstract:

    Objective: To detect the serum levels of retinol binding protein-4 (RBP-4) and glucose transporter-4 (GLUT-4) in the short-time (8 weeks) after duodenal-jejunal anastomosi (DJA) surgery and duodenal-jejunal bypass (DJB) surgery for type 2 diabetic rats,and attempt to explore theoretical basis and mechanisms of surgical treatment in type 2 diabetes. Methods: Type 2 diabetic rats were divided into the DJA surgery group (n=10), the DJB surgery group (n=10) and the sham surgery group (n=10). Weight, food intake, fasting blood glucose, fasting insulin, and RBP-4 level were measured before and after treatment. The glucose metablolism and insulin resistance before and after operation were evaluated. GLUT-4 level was detected at the 8th week after surgery. Results: Compared with the sham surgery group, the DJB and DJA groups showed decreased fasting blood glucose, reduced area under oral glucose tolerance test(OGTT) curve, improved insulin resistance, decreased BRP-4 level, and increased GLUT-4. Conclusion: DJA and DJB operation could significantly improve the glucose metabolism and insulin sensitivity of type 2 diabetic rats, which were independent of the weight loss, but related to decreased RBP-4 and increased GLUT-4 in skeletal muscle.

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卜和美,马向华,孙 婧,方 达.十二指肠空肠旁路术与十二指肠空肠吻合术对2型糖尿病大鼠视黄醇结合蛋白4的作用及意义[J].南京医科大学学报(自然科学版),2017,(9):1148-1153

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  • 收稿日期:2017-06-20
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  • 在线发布日期: 2017-09-25
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