摘要
目的探讨Roux-en-Y胃旁路术对2型糖尿病大鼠肝脏糖异生的影响及意义。方法将40只GotoKakizaki(GK)大鼠按随机数字表法分为Rollx-en-Y胃旁路术组(A组,20只)和假手术组(B组,20只)。分别于术前及术后1、2、4周行口服葡萄糖耐量实验(OGYr)。并记录体质量。于术前及术后第4周测定两组大鼠糖化血红蛋白(HbAlc)水平。术后第4周处死大鼠获取肝脏组织,采用反转录聚合酶链反应和Westernblot技术检测肝脏组织葡萄糖6磷酸酶(G-6-P)、磷酸烯醇式丙酮酸激酶(PEPCK)的mRNA及蛋白相对表达量。结果术后1、2、4周,A组大鼠平均空腹血糖分别为6.5、4.9和4.7mmol/L,而B组分别为10-3、10.4和12.5mmol/L。两组比较差异均有统计学意义(均P〈0.05);A组灌胃后2h血糖分别平均为8.3、6.4和5.5mmol/L,B组为21.4、23.8和24.7mmol/L,两组比较差异均有统计学意义(均P〈0.05)。A组术后第4周HbAlc为(6.8±1.0)%,低于B组的(7.9±0.8)%(P〈0.05)。A组术后4周肝脏G-6-P和PEPCK的mRNA相对表达较B组分别降低了21.0%和25.9%,蛋白表达水平也相应降低(均P〈0.05)。PAS染色示肝脏糖原沉积明显增多。结论Roux-en-Y胃旁路术后肝脏糖异生关键酶的mRNA相对表达和蛋白含量明显降低。肝脏糖异生减少.这可能是该术式的降糖机制之一。
Objective To investigate the influence and significance of gastric bypass surgery on hepatic gluconeogenesis in type 2 diabetic Goto Kakizaki (GK) rats. Methods Forty GK rats were randomly divided into Roux-en-Y gastric bypass group (group A) and sham operation group (group B). Differences in glucose tolerance experiment(OGTT) at preoperative and postoperative 1, 2 and 4 weeks were compared and weight was recorded. Glycated hemoglobin levels were measured preoperatively and 4 weeks postoperatively. The animals were sacrificed 4 weeks after surgery and liver tissues were harvested to detect the relative expression of mRNA and protein of glucose 6 phosphatase (G-6-P) and phosphoenol pyruvate kinase (PEPCK) with RT-PCR and Western blot. Results Fasting blood glucose levels were 6.5, 4.9, and 4.7 mmol/L in group A, and were 10.3, 10.4, and 12.5 mmol/L in group B, and the differences between two groups were statistically significant(P〈0.05). The blood glucose level at 2 h after stomach lavage were 8.3, 6.4 and 5.5 mmol/L in group A, and were 21.4, 23.8 and 24.7 mmol/L in group B at postoperative 1, 2, 4 weeks, and the differences between two groups were statistically significant(P〈0.05). The glycosylated hemoglobin at postoperative 4 weeks was(6.8±1.0)%, significantly lower than that in group B [(7.9±0.8)%, P〈0.05]. Hepatic G-6-P and PEPCK mRNA relative expression at postoperative 4 weeks was reduced by 21.0% and 25.9% respectively as compared to group B, and the protein expression reduced as well. Immunohistochemistry showed that hepaticglycogen sedimentary in group A increased significantly. Conclusion The relative mRNA and protein level of key enzymes of hepatic gluconeogenesis are significantly decreased after Roux-en-Y gastric bypass surgery and hepatic gluconeogenesis is reduced, which may be a potential mechanism of the decrease of blood glucose.
出处
《中华胃肠外科杂志》
CAS
2012年第11期1142-1145,共4页
Chinese Journal of Gastrointestinal Surgery
基金
全军临床高新技术重大项目(2010gxjs040)