【摘要】 目的:观察Roux-en-Y胃转流术对2型糖尿病大鼠的治疗效果,并探讨在胃转流术治疗2型糖尿病的机制中,血清Chemerin可能发挥的作用。方法:取成模2型糖尿病(T2DM)大鼠20只,随机分为两组,2型糖尿病手术组(DRO组)和2型糖尿病假手术组(DSO组),每组10只。另取周龄性别相匹配的非造模组SD大鼠20只,随机分为正常手术组(NRO组)、正常假手术组(NSO组),每组10只。分别于术前、术后第4周和术后第8周测定各组大鼠体重、空腹血糖(FPG)变化,ELISA法检测血清胰岛素及Chemerin水平变化,并分析血清Chemerin水平与体重、FPG及INS之间的相关性。结果:术前,DRO组与DSO组之间比较,各组大鼠的体重、FPG、INS及Chemerin水平差异均无统计学意义(P>0.05);NRO组与NSO组比较,各组大鼠的体重、FPG、INS及Chemerin水平差异也均无统计学意义(P>0.05);而FPG、INS及Chemerin水平在DRO组及DSO组中均分别明显高于NRO组(P<0.01),且均分别明显高于NSO组(P<0.01)。术后第4周,DRO组体重、FPG、INS及Chemerin水平较术前均下降,除体重(P>0.05)外,其余指标与术前比较差异均有统计学意义(P<0.05);术后第8周,体重、FPG、INS及Chemerin水平进一步下降,除体重(P>0.05)外,其余指标与术前比较差异均有统计学意义(P<0.01)。DSO组、NRO组及NSO组组内术前及术后第4周、第8周,体重、FPG、INS及Chemerin水平比较,差异均无统计学意义(P>0.05)。DRO组与DSO组在手术前及手术后4周、第8周中,其血清Chemerin水平与其对应血清INS水平均呈正相关(P<0.01),相关系数分别为r=0.720,r=0.469(P<0.01)。结论:Roux-en-Y胃转流术对T2DM大鼠血糖的控制起到一定的治疗作用,胃转流术后Chemerin水平下降,而且胰岛素敏感性得到提高,这可能是Roux-en-Y胃转流术治疗T2DM的机制之一。更多还原

【Abstract】 Objective:To observe the therapeutic effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus(T2DM)rats and explore the possible role of Chemerin in the mechanism of Roux-en-Y gastric bypass on T2DM.Methods:twenty SD rats with T2DM were randomly divided into 2 groups: T2DM-Roux-en-Y Gastric Bypass group(DRO group),and T2DM-sham operation group(DSO group),with 10 rats in each group.Another 20 age and sex matched normal SD rats were randomly divided into 2 groups:operation group(NRO group) and normal-sham operation group(NSO group),with 10 rats in each group.All the subjects were tested in terms of their weight,plasma glucose(FPG) level,serum insulin(INS) level and Chemerin level by ELISA,before operation and on week 4,8 after operation,respectively.The association between Chemerin and weight,FPG,INS was also analyzed.Results:Before operation,the weight,FPG level,INS level and Chemerin level in both DRO group and DSO group were not significantly different(P>0.05);neither in NRO group and NSO group(P>0.05);however,FPG level,INS level and Chemerin level in both DRO group and DSO group were significantly higher than those in NRO group respectively(P<0.01);it was the same result with NSO group compared with DRO group and DSO group(P<0.01).On the fourth week after operation,the weight,FPG level,INS level and Chemerin level in DRO group decreased respectively as compared with those before operation.All indexes,except the weight(P>0.05),had significant differences(P<0.05).On the eighth week after operation,all of the indexes further decreased.All indexes,except the weight(P>0.05),had significant differences(P<0.01).Comparing the index of weight,FPG level, INS level and Chemerin level in DSO group,NRO group and NSO group before operation,on the 4th week and 8th week after operation respectively,there was no significant difference(P>0.05).The changes in serum Chemerin level correlated positively with those in INS before operation and on both fourth and eighth weeks after operation in the DRO group and DSO group(r=0.720,r=0.469,respectively,P<0.01).Conclusion:Roux-en-Y gastric bypass has a therapeutic effect on T2DM rats.We can see that Chemerin level decreases and insulin resistance is improved after Roux-en-Y gastric bypass,which may be one of the therapeutic mechanisms of the Roux-en-Y gastric bypass for T2DM.更多还原