2型糖尿病患者Roux-en-Y胃旁路术后血糖、胃肠激素、调节性B细胞和应激激素的相关性

Correlation of blood glucose levels, Breg, gastrointestinal hormones and stress hormones after gastric bypass in patients with type 2 diabetes mellitus

目的研究2型糖尿病患者Roux-en-Y胃旁路术(RYGB)术后血糖水平、调节性B细胞(Breg)、胃肠激素、应激激素的相关性。方法选择2015年6月至2018年6月住院行RYGB的T2DM患者103例,术后根据疗效分为完全缓解组(n=88)和改善组(n=15),检测患者手术前后血糖水平、Breg、胃肠激素、应激激素,分析术后各指标间的相关性。结果完全缓解组术后12个月空腹血糖(FPG)、皮质醇(Cor)、去甲肾上腺素(NE)、胃饥饿素(Ghrelin)、瘦素(Leptin)明显低于改善组,Breg明显高于改善组(P<0.05)。两组治疗前、治疗后12个月胰高血糖素样肽(GLP)-1水平比较差异无统计学意义(P>0.05)。Breg与FPG、体重指数(BMI)呈正相关(r=0.842,0.703,均P<0.05),Ghrelin与FPG、BMI呈负相关(r=-0.659,-0.582,均P<0.05),Leptin与FPG、BMI呈负相关(r=-0.720,-0.697,均P<0.05),Cor、NE与FPG呈负相关(r=-0.347,-0.334,均P<0.05)。结论2型糖尿病患者RYGB术后Breg、胃肠激素、应激激素与血糖水平、BMI相关。

Objective To investigate the correlation between blood glucose level,regulatory B cells (Breg),gastrointestinal hormones and stress hormones after Roux-en-Y gastric bypass (RYGB) in type 2 diabetes mellitus (T2DM). Methods 103 patients with T2DM who were hospitalized with RYGB from June 2015 to June 2018 were selected and divided into the complete remission group ( n =88) and the improvement group ( n =15) according to the efficacy after surgery.The blood glucose level,Breg,gastrointestinal hormone and stress hormone before and after surgery were detected,and the correlation between postoperative indicators was analyzed. Results After operation 12 months,FPG,Cor,NE,Ghrelin and Leptin of the complete remission group were lower than those of the improvement group,and the Breg was higher than that of the improvement group ( P <0.05).Breg was positively correlated with FPG and BMI ( r =0.842,0.703, P <0.05),Ghrelin was negatively correlated with FPG and BMI ( r =-0.659,-0.582, P <0.05),Leptin was negatively correlated with FPG and BMI ( r =-0.720,-0.697, P <0.05),Cor and NE were negatively correlated with FPG ( r =-0.347,-0.334, P <0.05),there were statistical Significances(all P <0.05). Conclusions Breg,gastrointestinal hormone and stress hormone are related to blood glucose level and body mass after RYGB surgery in patients with T2DM.