十二指肠空肠旁路术和袖状胃切除术对糖尿病大鼠肝脏葡萄糖激酶表达的影响

Effects of duodental-jejunal bypasss and sleeve gastrectomy on the expression of liver glucokinase in diabetic rats

目的探讨十二指肠空肠旁路手术（DJB）和袖状胃切除术（SG）对糖尿病大鼠肝脏葡萄激酶（GCK）表达的影响。方法制作GK大鼠（非肥胖糖尿病大鼠）和正常SD大鼠DJB和SG两种术式的动物模型．动态观察术后空腹血糖和胰岛素的变化。术后8周取肝组织标本，分别采用实时定量RT—PCR和Western blot检测术后肝脏GCK mRNA和蛋白表达水平。结果GK大鼠DJB组和SG组术后各时间点空腹血糖均显著低于术前水平（均P〈0．01），假手术组1周内空腹血糖降低，2周后逐渐恢复到术前高水平：SD大鼠各种手术后血糖水平无明显改变（均P〉0．05）。GK大鼠DJB术后肝脏GCK mRNA和蛋白表达水平分别为1．45±0．29和494．25±30．25，SG术后分别为0．65±0．25和345．25±28．13;假手术组术后GCK mRNA和蛋白表达水平分别为1．05±0．19和409．13±26．86，与DJB组和SG组比较，差异有统计学意义（均P〈0．01）；对照组GCK mRNA和蛋白表达水平分别为1．04±0．17和404．75±30．90，与DJB组和SG组比较，差异具有统计学意义（均P〈0．01）。SD大鼠术后GCK表达也呈现了相似的变化。结论DJB和SG均能明显改善糖尿病大鼠的术后血糖水平．但两种术式对肝脏GCK的表达却具有完全不同的影响。

Objective To investigate the effects of duodental-jejunal bypasss （DJB） and sleeve gastrectomy （SG） on the expression of liver glucokinase （GCK） in diabetic rats. Methods Animal models of Goto-Kakizaki rats and Sprague-Dawley rats were established by DJB and SG. Results of fasting glycemia and insulin were compared. Liver tissue was harvested 8 weeks postoperatively. Quantitative real-time PCR and Western blot were used to detect liver GCK mRNA and protein expression after operation. Results Fasting plasma glucose levels of DJB group and SG group in GK rats were markedly declined 3 day and 1, 2, 4, 6, 8 weeks postoperatively （all P〈0.01 ）, while Sham group only droped 3 day and 1 week postoperatively, and there were no significant differences 2 weeks postoperatively （P〉0.05）. Fasting plasma glucose levels of each group in SD rats did not change after operation. In GK rats, GCK mRNA level （1.45±0.29） and protein expression （494.25±30.25） after DJB were higher than Sham group （1.05±0.19 and 409.13±26.86） and control group （ 1.04±0.17 and 404.75±30.90）. GCK mRNA level and protein expression after SG were 0.65 ±0.25 and 345.25 ±28.13 respectively, which were significantly lower than those in control group （all P〈0.01 ）. All the groups in SD rats experienced similar GCK expression change. Conclusion Both DJB and SG can decrease the plasma glucose levels of GK rats, while there are different effects on the expression of liver GCK.