| Objective:Roux-en-Y gastric bypass surgery is a new way to treat type2diabetes; its effect rate reaches up to90%. But untill now, theoretical mechanism related to this surgery is not yet fully developed. It has confirmed that in the pathogenesis of type2diabetes, abnormal increase of FFA concentration will produce ectopic deposition of triglycerides, and further promote the release of inflammatory cytokines by excessive accumulated adipose tissue. Therefore, the abnormal decomposition of fat tissue is closely related to the occurrence of type2diabetes insulin resistance. Then, will Gastric bypass surgery lead to the FFA content and inflammatory factors in the blood changed? If so, how does the changing trend go and what is its significance? There is No doubt, to clarify this issue will help to elucidate the mechanism of gastric bypass in the treatment of diabetes. With the spontaneous type2diabetic rats as experimental animals and using rat gastric bypass surgery as a research model, this project intends to observe the variation of the rats’FFA and inflammatory factors before and after the surgery, and its impact upon insulin resistance, purposing to systematically investigate the Insulin resistance variation and its occurrence mechanism, and thereupon to provide a theoretical basis for a wider clinical use of Roux-en-Y gastric bypass surgery.Method:First of all,40GK male rats with spontaneous diabetes are randomly divided into surgery group and control group, with gastric bypass surgery conducted to the surgery group, and transection and reanastomosis of the gastrointestinal tract to the control group respectively. Then,1,2and4weeks before and after the surgery, dynamic measurement is made to the rats in both group respectively, so as to record their body mass index, fasting plasma glucose, oral glucose tolerance test blood glucose2h(OGTT2h) and fasting insulin with the HOMA-IR calculated.4week preoperatively and postoperatively, the rats’fatty acid (FFA), tumor necrosis factor-a (TNF-alpha), C-reactive protein (CRP) and cholesterol (Tch), triglyceride (TG) are all measured accordingly. Besides, the rats’liver tissue is respectively obtained during of and at the4th week after the surgery; with the method of immunohistochemistry oil red O staining, the liver TG deposition is observed, and its average gray value is calculated by Image-Pro plus6.0graphics image processor.Result:Comparing with the control group, the weight of the rats in the surgery group become significantly lighter than that before the surgery(P<0.01) one week after the surgery; and its blood glucose of postoperative fasting and of OGTT2h decreases noticeably which at the fourth week becomes further lower than the preoperative record (P<0.05). In the contrast, there is no obvious change reflected in the fasting and OGTT2hAt the4th week, of the surgery group, the content of Fasting plasma FFA, TG and TNF-alpha and CRP in the rats’ blood are significantly decreased (P<0.05). Meanwhile, the Insulin resistance index of the rats in surgery group obviously decreases(P<0.05), but no obvious change shows up in fasting insulin and Tch. Differently, there is no significant changes reflected in the above indicators of the control group. Moreover, according to the histopathology observation, TG deposition within the slice is markedly improved at the fourth week (P<0.05), but no obvious change in the control group (P>0.05).Conclusion:Gastric bypass surgery can significantly reduce the rats’ blood glucose. After the surgery, GK rats’ usual disordered machine lipid metabolism is corrected, and especially the FFA content in there blood is decreased significantly, which result in the release of inflammatory factors reduced and eventually lead to insulin resistance significantly alleviated which is an important mechanism of its hypoglycemic. |
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