胃旁路术对糖尿病大鼠糖脂代谢的影响

Effects of gastric bypass on carbohydrate and lipid metabolism in diabetic rats

目的 观察Roux-en-Y胃旁路术对糖尿病Coto-Kakizaki（CK）大鼠糖脂代谢的影响.方法 18只GK大鼠随机等分为Roux-en-Y胃旁路手术组（RYGB组）、假RYGB组和对照组;观察手术后1、2、4、12周各组大鼠空腹血糖、C肽和体质量增加值变化,同时观察手术后4周、12周血浆糖化血红蛋白、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇含量变化.结果 手术前3组大鼠各检测指标差异无统计学意义（P〉0.05）.手术后1、2、4、12周RYGB组大鼠空腹血糖（7.0±0.8比6.5±1.0比6.3±1.5比5.6±1.7比4.3±0.5,P〈0.01）明显降低,空腹C肽（0.21±0.06比0.28±0.09比0.52±0.06比0.71±0.06比0.78±0.06,P〈0.01）显著升高;手术后4、12周大鼠糖化血红蛋白（9.71±1.34比9.09±1.21比7.34±1.17,P〈0.01）、甘油三酯（1.32±0.17比0.87±0.05比1.22±0.15,P〈0.01）、低密度脂蛋白胆固醇（1.61±0.25比1.21±0.20比1.16±0.15,P〈0.01）明显降低,高密度脂蛋白胆同醇（0.83±0.10比1.11±0.12比1.23±0.16,P〈0.01）明显升高（P〈0.01）.各组大鼠体质量增加值差异均有统计学意义（P〈0.05）.假RYGB组和对照组其余各检测指标的变化差异均无统计学意义（P〉0.05）.结论 Roux-en-Y胃旁路术可改善非肥胖糖尿病GK大鼠血糖和血脂代谢,且与体质量变化无关.

Objective To observe the effects of gastric bypass on carbohydrate and lipid metabolism in Goto-Kakizaki （GK） type 2 diabetic rats. Methods Eighteen male GK rats were randomly divided into Roux-en-Y gastric bypass （RYGB） group, sham RYGB group （sham-RYGB） and pair-fed control group. Before and 1, 2, 4, 12 weeks after operation, the values of fasting glucose （FPG）, weight gain and C-peptide （FC-P） were measured, and levels of glycosylated hemoglobin （GHbAlc） , triglycerides （TG） , high density lipoprotein （HDL-c） and low density lipoprotein （LDL-c） were determined before and 4, 12 weeks after operation. Results No significant differences were observed in pre-operative values （P〉0. 05） among three groups. In RYGR group, serum levels measured before and 1, 2, 4, and 12 weeks after operation were as follows：FPG （7.0±0. 8 vs. 6. 5 ±1.0 vs. 6. 3±1. 5 vs. 5. 6±1. 7 vs. 4. 3±0.5, P〈0.01）, FC-P（0.21±0.06 vs. 0.28±0.09 vs. 0. 52±0. 06 vs. 0.71±0.06 vs. 0.78±0.06,P〈0. 01） ;levels of GHbAlc （9. 71±1. 34 vs. 9. 09±1. 21 vs. 7. 34±1. 17,P〈0. 01 ） , TG （1.32±0.17 vs. 0.87±0.05 vs. 1. 22±0.15,P 〈0.01）, and LDL-c （1.61 ±0.25 vs. 1.21 ±0.20 vs. 1. 16 ±0.15,P〈0.01）, HDL-c （0.83 ±0.10 vs. 1.11 ±0.12 vs. 1.23 ±0. 16,P〈0.01） before and 4, 12 weeks after operation. Weight gains had significant difference in each group before and after operation.In sham-RYGB and control groups, no significant differences were observed before and after operation in values of the other parameters. Conclusion Roux-en-Y gastric bypass can significantly regulate the metabolism of carbohydrate and lipid in GK rats, and the effects are not associated with weight gain.