Study On The Relationship Between Hypoglycemic Effect Of Duodenal Jejunum Bypass And Non - Obese Type 2 Diabetes Mellitus GK Rats And Glucagon

Objective:To investigate the effect and potent mechanism of duodenal-jejunal bypass(DJB) in non-obese type2diabetes Goto-Kakizaki(GK) rats.Methods:(1)Packet:eighteen male GK rats and eighteen male Wistar rats were randomly divided into four groups:GK operation group(group A), GK sham operation group(group B), Wistar operation group(group C), Wistar sham operation group(group D).There were9rats in each group. Preoperative group A and group B, group C and group D, weight, the average food intake, fasting blood glucose was no significant difference.(2)Interventions:group A and group B operate DJB surgery, preoperative ban eating rats12-14hours, open water,10%Chloral hydrate(3-4ml/kg) intraperitoneal injeetion on the operating table after anesthesia fixed, aseptic conditions, on the middle abdominal ineision into the abdominal incision3cm long, cut pylorus, closed duodenal stump, cut off10cm from the Treitz ligament jejunum, distal jejunum and pylorus end-to-end anastomosis, from gastric-jejunum anastomotic line jejunum15cm distal end-to-side anastomosis. group C and group D operate sham surgery, cut pylorus and jejunum as same as operation group, then end-to-end anastomosis.The average operation time was about1hour, after the completion of2ml were washed with gentamicin, abdominal closure.(3) Detection target:body weight, fasting plasma glucose, plasma glucagon-like peptide-1level(GLP-1) were determined before and after surgery. Oral glucose tolerance test(OGTT) was measured preoperative and postoperative8weeks,2-hour postprandial GLP-1was detected, the area under blood glucose concentration curve(AUC) was calculated. The ileum tissue proglucagon(PG) mRNA levels were assayed by semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR).And tissue GLP-1was also determined.Results:(1)Weight:after surgery1week, rats weight decreased apparently compared with the preoperative results in all groups(P<0.01). Rats weight gradually increased postoperative1week,2weeks,3weeks,4weeks,8weeks; Weigh change of all time points showed no significant changes in group A and group B, group C and group D (P>0.05).(2) Fasting plasma glucose:postoperative1week, fasting plasma glucose in group A had started to decrease, and it decreased from preoperative (8.76±0.65)mmol/L to (6.54±1.04)、(6.30±0.94)、(6.63±0.71)、(6.27±1.14)、(5.95±0.78)mmol/L1,2,3,4,8weeks post operation(P<0.01), respectively. Fasting plasma glucose levels in group A were lower than that of group B at the same time points(P<0.05).In the experiments, fasting plasma glucose had no significant change in group B, group C and group D.(3)The area under blood glucose concentration curve:postoperative8weeks, AUC of group A decreased from preoperative (68.86±8.40) mmol·h/Lto (47.32±1.79) mmol·h/L, the difference had statistical significance(p<0.05), AUC of group A was lower than that of group B at the same time points(P<0.05). AUC had no significant change in group B, group C and group D.(4) Plasma GLP-1:postoperative1week, fasting plasma GLP-1in group A had started to increase, and it increased from preoperative (7.69±0.74)pmol/Lto(13.10±2.29)、(27.52±4.73)、(29.00±3.94)pmol/L1,4,8weeks post operation(P<0.01), respectively. Fasting plasma GLP-1in group A were higher than that of group B at the same time points(P<0.05), so did postprandial GLP-1change. In the experiments, fasting and postprandial plasma GLP-1had no significant change in group B, group C and group D.(5) Postoperative8weeks, tissue GLP-1of group A had increased compared with group B, but had no statistical significance. The fasting plasma glucose was negatively corrected with plasma and tissue GLP-1(P<0.01), and tissue GLP-1was positively corrected with plasma GLP-1(P<0.01).(6) The ileum tissue proglucagon mRNA levels in group A obviously increased that of group B, and had statistical significance(p<0.05).There was no statistical significance in group C and group D.Conclusions:DJB can markly improve blood glucose in non-obese type2diabetic rats, independently of effects on weight lose. It suggests that non-obese type2diabetes patients also may achieve hypoglycemic effect by operation in clinical. The hypoglycemic effects may be contributed to increasing synthesis of the ileum tissue proglucagon mRNA, and more plasma and intestine tissue GLP-1secretion after DJB.