Roux-en-Y 胃旁路术对肥胖合并 2 型糖尿病大鼠肝脏糖脂代谢 的影响#br#
Effect of Roux-en-Y gastric bypass surgery on hepatic glucolipid metabolism in rats with obesity combined with type 2 diabetes mellitus#br#

目的 · 通过构建肥胖合并2 型糖尿病（T2DM）Roux-en-Y 胃旁路手术（RYGB）大鼠模型，探讨RYGB 对大鼠肝脏糖脂代 谢的影响及其机制。方法 · 将大鼠随机分为正常对照组、高脂饮食+DM 组、假手术组、手术组，每组10 只。监测大鼠体质量、进 食量、腹腔糖耐量试验（IPGTT）以及胰岛素耐量试验（ITT）结果的变化，并检测法尼醇 X 受体（FXR）、成纤维细胞生长因子 21 （FGF21）、葡萄糖 -6- 磷酸酶（G6Pase）的 mRNA 和蛋白表达水平。结果 · 与高脂饮食 +DM 组和假手术组比较，手术组大鼠体质量 和进食量明显下降，IPGTT、ITT 曲线下面积明显减小；肝脏油红 O 染色可见手术组大鼠红色脂滴较高脂饮食 +DM 组和假手术组明 显减少；手术组的FXR、FGF21 mRNA 表达明显升高，G6Pase mRNA 表达降低；手术组FXR、FGF21 蛋白表达明显升高，G6Pase 蛋白表达降低。结论 · RYGB 可以激活 FXR-G6Pase 通路，有效改善肥胖合并 T2DM 大鼠的糖脂代谢。
：Objective · To study the effects of Roux-en-Y gastric bypass (RYGB) surgery on hepatic glycolipid metabolism in the rat models with obesity combined with type 2 diabetes mellitus (T2DM) and investigate the molecular mechanisms involved. Methods · The rats were randomly divided into control group, high-fat diet+DM group, sham-operated group and operated group, ten each. The changes of body weights and food intakes, as well as the results of intraperitoneal glucose tolerance test (IPGTT) and insulin tolerance test (ITT) were monitored. The mRNA and protein expressions of farnesoid X receptor (FXR), fibroblast growth factor 21 (FGF21) and glucose-6-phosphatase (G6Pase) were respectively detected. Results · The body weights and food intakes were significantly reduced in operated group, as compared to the high-fat diet+DM group and sham-operated group.The areas under the curve of IPGTT and ITT in operated group were reduced. Meanwhile, red lipid droplets of the operated group were obviously less than those of high-fat diet+DM group and sham-operated group by oil red-O staining. Furthermore, the mRNA expressions of FXR and FGF21 in operated group were significantly higher than those of high-fat diet+DM group and sham-operated group, while G6Pase mRNA expression was reduced. The protein levels of FXR and FGF21 were also higher in operated group than in high-fat diet+DM group and sham-operated group, but G6Pase level was decreased. Conclusion · RYGB could improve the glycolipid metabolism of rats with obesity combined with T2DM by activating FXR-G6Pase pathway