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目的观察回肠转位术(ileal transposition,IT)对非肥胖型2型糖尿病GK大鼠的血糖及胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)的影响,探讨IT对GK大鼠的降糖作用及其可能的机制。方法随机数字表法将20只雄性正常体质量GK大鼠分为回肠转位术组(IT组)和假手术组(Sham组),每组10只。观察并测定两组GK大鼠术前及术后1周、2周、1个月、2个月、3个月、6个月的体质量、空腹血糖(fasting blood glucose,FBG)、血清胰岛素(fasting insulin,INS)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、GLP-1水平的变化。结果 IT组与Sham组手术前后体质量比较无统计学差异(P>0.05)。与术前比较,术后1周~6个月IT组GK大鼠FBG明显降低(P<0.05),空腹GLP-1明显升高(P<0.05),术后3个月和6个月HbA1c明显降低(P<0.05)、INS水平明显升高(P<0.05)。Sham组上述指标均未见明显变化。结论 IT对GK大鼠有明显的降糖作用,其机制可能是食物提前进入回肠,刺激GLP-1分泌增加,从而促进胰岛素释放,促进β细胞增生并抑制其凋亡。
Objective To investigate the effect of ileal transposition (IT) on the blood glucose and glucagon-like peptide-1 (GLP-1) in non-obese Type 2 diabetic GK rats. Hypoglycemic effect on GK rats and its possible mechanism. Methods Twenty male normal weight GK rats were divided into ileum transposition group (IT group) and sham operation group (Sham group) by random number table. The body weight, fasting blood glucose (FBG), serum insulin level and serum insulin level in GK rats were observed and measured at 1 week, 2 weeks, 1 month, 2 months, 3 months and 6 months after operation. (fasting insulin, INS), glycosylated hemoglobin (HbA1c), GLP-1 level changes. Results There was no significant difference in body mass between IT group and Sham group before and after operation (P> 0.05). Compared with preoperative, the FBG of GK rats in IT group decreased significantly (P <0.05), the GLP-1 of fasting group increased significantly (P <0.05), the levels of HbA1c in 3 months and 6 months after operation (P <0.05), INS level was significantly increased (P <0.05). Sham group showed no significant changes in the above indicators. Conclusions IT has a significant hypoglycemic effect on GK rats. The mechanism may be that food enters the ileum in advance and stimulates the secretion of GLP-1, thereby promoting insulin release, promoting β-cell proliferation and inhibiting apoptosis.