T2DM大鼠行Roux-en-Y胃旁路术后血清Ghrelin和Visfatin水平的变化及意义

The Change and Significance of Serum Ghrelin and Visfatin after Roux-en-Y Gastric Bypass Surgery in Treatment of Type-2 Diabetes Mellitus Rats

目的探讨Roux-en-Y胃旁路术(Roux-en-Y gastric bypass surgery,RYGB)后2型糖尿病(T2DM)大鼠血清中生长激素释放肽(Ghrelin)和内脂素(Visfatin)水平的变化及其意义。方法先将30只健康雄性8周龄SD大鼠随机分为糖尿病组22只和空白对照组(CSO组)8只。糖尿病组的22只大鼠给予高脂高糖饮食6周后,再腹腔注射链脲佐菌素(streptozotocin,STZ),最终成功建立T2DM大鼠模型18只。将建模成功的18只大鼠再随机分为RYGB组10只和假手术组(DSO组)8只。RYGB组大鼠接受RYGB,DSO和CSO大鼠接受假手术。分别于术前和术后4周测定3组大鼠的空腹血糖(FBG)、空腹血清胰岛素(FINS)、Ghrelin及Visfatin水平,计算术后4周时的肥胖指数和胰岛素敏感指数(ISI),进行组间比较。结果相较于术前,RYGB组大鼠的体质量、肥胖指数、FBG水平、FINS及Visfatin水平均降低(P<0.050),ISI值和Ghrelin水平升高(P<0.050),但DSO组和CSO组大鼠手术前后的体质量、体长、肥胖指数、FBG水平、FINS水平、ISI值、Ghrelin水平及Visfatin水平比较差异均无统计学意义(P>0.050)。此外,3组大鼠手术前后的Ghrelin和Visfatin水平的差值比较差异均有统计学意义(P<0.001),RYGB组的Ghrelin、Visfatin水平的差值较DSO组和CSO组大(P<0.050),但DSO和CSO组的Ghrelin、Visfatin水平的差值比较差异均无统计学意义(P>0.050)。结论术后血清Ghrelin水平的升高和Visfatin水平的降低可能是RYGB治疗肥胖型T2DM的重要机理。

Objective To research the change and significance of Ghrelin and Visfatin in plasma after Roux- en-Y gastric bypass surgery （RYGB） in type-2 diabetes （T2DM） rats. Methods Thirty healthy Sprague Dawley （SD） rats （8 weeks） were divided into T2DM group （n=22） and blank control group （CSO group, n=8）. Then rats of T2DM group were fed with high calorie and high sugar diet for 6 weeks, following by one dose of streptozotocin via intraperitioneal injection. Finally, there were 18 T2DM rats were successfully established. Then those 18 T2DM rats were divided into two groups： RYGB group （n=10） and sham operation group （DSO group, n=8）. Rats of RYGB underwent RYGB, rats of DSO group and CSO group underwent sham operation. Levels of fasting serum glucose （FBG）, fasting serum insulin （FINS）, Ghrelin, and Visfatin of rats in 3 groups were detected by enzyme-linked immunoassay （EIA） before and 4 weeks after operation, and calculating the lee index and insulin sensitivity index （ISI）. Results In RYGB group, compared with before operation, the body weight, lee index, levels of FBG, FINS, and Visfatin decreased after 4 weeks after operation （P〈0.050）, but level of ISI and Ghrelin increased （P〈0.050）, while there was no significant difference in body weight, body length, lee index, ISI, levels of FBG, FINS, Ghrelin, and Visfatin in DSO and CSO group before and 4 weeks after operation （P〉0.050）. In addition, there was statistical difference among the 3 groups in difference before and after operation of Ghrelin and Visfatin, the difference before and after operation of Ghrelin and Visfatin was larger than those of DSO group and CSO group （P〈0.050）, but the difference was not significant differed between DSO group and CSO group （P〉0.050）. Conclusions The increase of plasma Ghrelin and the decrease of Visfatin play important role in the mechanism after RYGB in treatment of T2DM rats.