| Objective: To explore the different Roux-limb length of duodenal-jejunum bypass(DJB)on type 2 diabetic rats(Goto-kakizaki)of its body weight,fasting blood glucose(FBG)and glucagon-like peptide-1(GLP-1),glucose-dependent insulinotropic polypeptide(GIP),ghrelin,leptin,adiponectin,somatostatin of the gastrointestinal hormone changes and GLP-1 receptors in the stomach,and duodenum anastomotic,duodenal stump and common pathways of jejunum postoperative expression and its related mechanism.Methods: 40 GK rats were randomly divided into five groups(n=8)by lottery,and the control group was re-anastomosed after duodenal dissection as group A,the surgery group performed DJB with different length of Roux intestinal progenitor and retained 10,20,30,40 cm of Roux intestinal progenitor as group B,C,D,E,respectively.All rat orbital venous blood was taken on the 3rd day before surgery and the 1th,3,5 and 8 weekends after surgery,and the body mass and fasting blood glucose values of each rat were detected dynamically,and the fasting GLP-1 level,GIP,ghrelin,leptin,adiponectin,somatostatin levels of each rat was determined by enzyme-linked immunosorbent assay(ELISA).After 8 weeks of GK rats,three specimens were taken from gastroduodenal anastomosis,duodenal stump and common pathway jejunum,and GLP-1 receptor expression was analyzed by immunohistochemistry.Results:(1)The success rate of operation of 40 GK rats in the whole group was 72.5% and the survival rate was 60% in the whole test period.the group E of retained 40 cm Roux loop was died during 3-5 weeks after surgery;(2)The blood glucose level of the DJB group was significantly decreased after operation and the blood glucose drop was not obvious after the control group.By the 8th week after operation the B group of DJB operation group decreased from(12.84±1.21)mmol·L-1 to(7.32±0.61)mmol·L ?1(P<0.05);the operation group C group(12.98±1.41)mmol L-1 decreased to(6.15±0.34)mmol·L-1(P<0.05);group D of surgery group decreased from(12.92±1.04)mmol·L-1 to(5.98±0.48)mmol·L-1(P<0.05);However in the 3 weeks after operation the E group of DJB surgery group decreased from(13.23±1.14)mmol·L-1 to(5.75±0.33)mmol·L-1(P<0.05)and the decrease was the most obvious;(3)(3)There was no significant change in body weight between 1-8 weeks after operation in the control group and the operation group(P?0.05);(4)(4)GLP-1 in the DJB operation group decreased after operation but the control group did not decrease significantly after operation.There was a difference between the operation group and the preoperative group(P<0.05)and the more obvious the decline with Roux intestinal fistula the most obvious in the surgery group D;(5)Compared with the preoperative and control groups,the postoperative GIP in DJB surgery group was significantly lower than that in the control group(P < 0.05),and decrease in group D was the most significant in the inferior bulge.(6)Compared with the preoperative and control groups,the decrease of Ghrelin in DJB surgery group was statistically significant(P <0.05),and the decrease of Ghrelin in group D was the most significance.(7)Compared with the control group,the leptin in the DJB operation group decreased but the two were not statistically significant(P?0.05),but the operation group and the control group were significantly lower after operation than before operation,and there were statistically different(P<0.05).(8)Compared with the preoperative and control groups,the postoperative adiponectin level in the DJB surgery group was significantly higher than that in the control group(P<0.05)and the D group was the most obvious in the 8th week.(9)For somatostatin there was no significant change in the DJB group after surgery compared with the control group(P?0.05);(10)Compared with the GLP-1 receptor in the control group,each DJB surgery group was accompanied by Roux loop extension the GLP-1 receptor in the gastric duodenum and the common pathway jejunum gradually increased(P<0.05),especially in Group D,while the GLP-1 receptor decreased at the posterior flexor ligament of the duodenal stump(P<0.05).Conclusion: Duodenal jejunum Bypass(DJB)had little effect on the weight of GK rats but had a hypoglycemic effect,and the effect of reducing sugar increased with the prolongation of the length of Roux's bowel loop,and the addition of Adiponectin after operation with the prolongation of the length of roux bowel loops,other GLP-1,GIP,Ghrelin,leptin and so on decreased,while Somatostatin was basically unchanged,and the mechanism of lowering blood sugar may be related to the expression of GLP-1 receptor in each intestine segment,and the results showed that the expression of GLP-1 receptor in the flow of food increased with the prolongation of the length of Roux. |
PDF Full Text Request