改良胃袖状切除对肥胖大鼠ghrelin及胰高血糖素样肽-1水平的影响

Effect of Modified Sleeve Gastrectomy on Ghrelin and Glucagon Like Peptide-1 in Rats with Diet Induced Obesity

目的根据胃肠道不同部位激素分泌的特点,探讨一种新的长期减重效果明显的手术方式。方法高脂饮食诱导Wistar肥胖大鼠35只,然后将诱导成功的肥胖大鼠按完全随机方法分为改良胃袖状切除术组(n=12)、胃袖状切除术组(n=12)及假手术组(n=11)3组,分别比较3组大鼠术前、术后连续8周的体重和摄食量,以及术前及术后第8周时外周血清中生长激素释放肽ghrelin和胰高血糖素样肽-1(GLP-1)水平的变化。结果①大鼠体重和摄食量:3组间术前大鼠的体重和摄食量差异均无统计学意义(P>0.05)。改良胃袖状切除术组和胃袖状切除术组术后1～8周,大鼠的体重均较假手术组明显下降(P<0.05),改良胃袖状切除术组较胃袖状切除术组大鼠的体重也明显下降(P<0.05)。改良胃袖状切除术组术后1～8周大鼠的摄食量较假手术组明显减少(P<0.05),改良胃袖状切除术组于术后3、6、7及8周大鼠的摄食量较胃袖状切除术组大鼠明显减少(P<0.05)。②外周血清中ghrelin和GLP-1水平:3组间术前大鼠ghrelin和GLP-1水平变化差异均无统计学意义(P>0.05);术后第8周,血清ghrelin水平改良胃袖状切除术组和胃袖状切除术组均较假手术组明显下降(P<0.05),改良胃袖状切除术组又较胃袖状切除术组明显下降(P<0.05);GLP-1水平改良胃袖状切除术组较假手术组和胃袖状切除术组明显升高(P<0.05)。同时,术后第8周时改良胃袖状切除术组和胃袖状切除术组ghrelin水平较术前明显下降(P<0.05),GLP-1水平在改良胃袖状切除术组较术前明显升高(P<0.05)。结论改良胃袖状切除术在肥胖大鼠模型中成功实施为进一步探索其临床应用提供了可能。

Objective To explore a surgery of effective weight loss concentrating on gut hormone release.Methods Wistar rats were fed with high-fat diet for inducing obesity and which randomly divided into sleeve gastrectomy plus decent jejunoileal bypass（SJB） group（n=12）,sleeve gastrectomy（SG） group（n=12）,and sham operation（SO） group（n=11）,the body weight reduction,food intake,plasma ghrelin level,and glucagon like peptide-1（GLP-1） level were compared among three groups.Results There were no differences of the body weight and food intake before operation among three groups（P0.05）.Compared with the SO group,the body weight descended and the food intake decreased obviously on 1-8 weeks after operation in the SJB group（P0.05）,the body weight of rats on 1-8 weeks after operation in the SJB group significantly descended as compared with the SG group（P0.05）,and the food intake of rats on week 3,6,7,and 8 in the SJB group signicantly decreased as compared with the SG group（P0.05）.There were no differences of the levels of the plasma ghrelin and GLP-1 before operation among three groups（P0.05）.Compared with SO group,the plasma ghrelin level decreased and the GLP-1 level increased in the SJB group and the SG group,meanwhile the SJB group significantly decreased level of plasma ghrelin and elevated level of plasma GLP-1 as compared with the SG group on week 8 after operation（P0.05）.Conclusion The data demonstrate that SJB could represent an effective way of losing weight by interfering with food intake and obesity related hormone levels.