胃旁路术对2型糖尿病大鼠血糖及瘦素的影响

发布时间：2018-04-16 14:32

本文选题：胃旁路术 + 2型糖尿病　；参考：《吉林大学》2015年硕士论文

【摘要】：目的：胃旁路手术是用于治疗肥胖症的常用手术方式，以往研究中还发现合并2型糖尿病的肥胖患者在实施这一手术后，除了体重可以有一定幅度的下降外，糖尿病症状在一定程度上也可得到相应的缓解，但其作用机制尚不完全清楚。本研究通过观察胃旁路术对2型糖尿病大鼠的治疗效果，以及血清和肝脏瘦素水平的改变，探讨瘦素水平对肥胖及2型糖尿病的关系，进而探索胃旁路术治疗2型糖尿病的潜在机制。方法：研究以Wistar大鼠为研究对象，共需要120只，随机分成三组，第一组是手术实验组（O组）数量为60只，第二组为假手术实验组（S组）数量为40只，第三组为对照组（C组）数量为20只。为了本实验制造2型糖尿病模型，将O组及S组大鼠进行4周的高脂饮食喂养后，并对其腹腔进行链脲佐菌素（STZ）注射，针对完成模型制造的O组和S组分别施以胃旁路手术。C组的Wistar鼠则无需特殊饲养处理。针对每组研究对象的空腹以及随机血糖和体重变化做四次检测，于术前和术后第l、2、4周检测各组大鼠随机血糖、空腹血糖、体重和瘦素的变化，通过酶联免疫吸附实验(ELISA)方法，在术前和术后第4周检测肝脏瘦素的变化。结果：1、与术前相比，O组大鼠在术后第2周的空腹和随机血糖均明显降低，空腹血糖由术前的19.62.5mmol/L降低到术后的7.32.1mmol/L（P0.05），随机血糖含量则由术前的28.82.7mmol/L降至术后11.72.7mmol/L（P0.05）。手术后第四周的两个血糖测定值都比较稳定，空腹值是4.91.9mmol/L（P0.05），随机值是10.72.6mmol/L（P0.05）。对比手术前后，S组和C组大鼠的空腹血糖和随机血糖变化并没有显著性差异（P0.05）。2、从术后第4周开始，O组大鼠的体重有显著下降，从手术前的27923.8mg降到了19912.3mg（P0.05）。S组和C组的瘦素水平在手术前后的变化则无显著性差异（P0.05）。3、手之术后第二周，对手术组大鼠体内的血清瘦素水平进行测定，测得的血清瘦素含量在手术后第二周发生了显著减少，从5.90.52ng/ml降至2.10.5ng/ml（P0.05），，手术以后第四周测得含量数值为1.90.5ng/ml（P0.05）。跟手术前比对发现，S组跟C组在这两组检测指标上也没有明显变化（P0.05）。4、手术后第四周的指标测量发现，手术之后的第四周，对于O组的大鼠瘦素水平的测量结果来看，有显著提升，含量则由0.040.02ng/mg提高到0.360.31ng/mg（P0.05）。S组以及C组的指标测量结果都没有明显变化（P0.05）。结论：Wistar糖尿病大鼠的空腹血糖、随机血糖和体重，在经过胃旁路术后均显著降低。胃旁路术可调节血清中瘦素的浓度，使血清瘦素浓度降低，这对改善血糖水平、减轻体重发挥重要的功效，可以很好的减轻2型糖尿病症状。并且，通过此手术，能够提高肝脏瘦素的含量水平，可以极大改善肝胰岛素的抵抗，进而对于2型糖尿病的缓解以及治疗都会产生有利影响。
[Abstract]:Objective: gastric bypass surgery is commonly used to treat obesity. Previous studies have also found that obese patients with type 2 diabetes can lose their weight by a certain extent after this operation.The symptoms of diabetes can also be alleviated to some extent, but its mechanism is not completely clear.By observing the therapeutic effect of gastric bypass surgery on type 2 diabetic rats and the changes of serum and liver leptin levels, the relationship between leptin level and obesity and type 2 diabetes mellitus was studied.To explore the potential mechanism of gastric bypass surgery in the treatment of type 2 diabetes.Methods: a total of 120 Wistar rats were randomly divided into three groups: the first group was the experimental group (n = 60) and the second group was the sham operation group (n = 40).The third group was control group C (n = 20).In order to establish the model of type 2 diabetes mellitus, the rats in group O and group S were fed with high-fat diet for 4 weeks and were injected with streptozotocin (STZ) intraperitoneally.Wistar rats in group O and group S were treated with gastric bypass surgery respectively without special feeding.The changes of fasting blood glucose, fasting blood glucose, body weight and leptin in each group were measured four times before and 4 weeks after operation. The changes of blood glucose, fasting blood glucose, body weight and leptin in each group were measured by enzyme linked immunosorbent assay (Elisa).The changes of liver leptin were detected before and 4 weeks after operation.Results compared with those before operation, the fasting and random blood glucose of rats in the O group decreased significantly from preoperative 19.62.5mmol/L to 7.32.1 mmol / L P 0.05, and the content of random blood glucose decreased from preoperative 28.82.7mmol/L to 11.72.7 mmol / L / L P 0.05.At the fourth week after operation, the two blood glucose levels were stable, with an fasting value of 4.91.9 mmol / L (P 0.05) and a random value of 10.72.6 mmol / L (P 0.05).There was no significant difference in fasting blood glucose and random blood glucose between group S and group C before and after operation. The weight of rats in group O decreased significantly from the 4th week after operation.The level of leptin in group 19912.3mg(P0.05).S and group C had no significant difference before and after operation from 27923.8mg before and after operation. The serum leptin level of rats in operation group was measured at the second week after operation.The serum leptin level was significantly decreased from 5.90.52ng/ml to 2.10.5ngml / ml P0.05N in the second week after operation, and was 1.90.5ng / ml / ml P0.05N at the fourth week after operation.Comparing with pre-operation, we found that there was no significant change in the detection indexes between group S and group C in these two groups. The index measurement in the fourth week after operation found that the leptin level in group O was measured in the fourth week after operation.There was a significant increase in the content from 0.040.02ng/mg to 0.360.31ng/mg(P0.05).S and C group. There was no significant change in the measurement results of P0.05.Conclusion the fasting blood glucose, random blood glucose and body weight of Wistar rats were significantly decreased after gastric bypass.Gastric bypass can regulate serum leptin concentration and reduce serum leptin concentration, which plays an important role in improving blood glucose level and reducing body weight, and can alleviate the symptoms of type 2 diabetes.Through this operation, the level of leptin in the liver can be increased, and the insulin resistance in the liver can be greatly improved, which will have a beneficial effect on the remission and treatment of type 2 diabetes mellitus.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R656.6

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