| Objective: Comparison of different sections of the small intestine bypass gastric bypass surgery for the treatment of type 2 diabetes and insulin resistance by analyzing the four groups of rats before and after surgical treatment of fasting blood glucose levels, islet function, body weight of and postoperative changes in rats to determine the incidence of malnutrition in the best area of the small intestine bypass the effect.Methods: 32 8 to 10 weeks old male GK rats similar weight were randomly divided into four groups of eight. Group 1: control group, from the rear in gastroduodenal anastomosis; Group 2: duodenal bypass group, to retain a full stomach and duodenum exclusion; Group 3: jejunal bypass group reservations stomach and duodenum jejunum plus full exclusion; group 4: ileal bypass group, to retain full stomach and duodenum plus jejunum and ileum exclusion. Get rats before and after surgery, respectively, after the first 1,3,6,12 eyes and peripheral blood using a blood glucose meter, four groups of animals dynamic measurement of fasting blood glucose levels and body mass animal electronic scales; enzyme-linked immunosorbent assay(ELISA) in serum insulin before and after surgery all rats, GLP-1 changes, the final calculation of insulin resistance index(HOMA-IR).Results: All 32 rats success rate of 90%, the fourth group of rats after 3 to 4 weeks have died due to severe malnutrition. And at the same time point in the control groupcompared with the preoperative, GBP surgery group(2,3,4 group) after fasting glucose levels have different rate dropped to 12 weeks after surgery, group 2 fasting glucose levels by 14.98 ± 2.17 decreased to 5.23 ± 0.70, the difference was statistically significant(P <O.05), group 3 fasting glucose levels decreased from 15.20 ± 1.92 to 5.29 ± 0.42, the difference was statistically significant(P <O.05), which group 3 is particularly significant. Compared with preoperative Thursday after the first group of GK rats body weight increased slightly, the first week in addition to the fourth group 3,6,12 other groups outside the physical volume of rats was significantly increased in group 4 rats body mass decreased significantly after surgery(P <O.05). And at the same time point in the control group compared with the preoperative, GBP surgery group(2,3,4 group), 3 weeks after fasting insulin rises, the first six weeks began to decline slightly, to 12 weeks significantly decreased in group 2 decreased from 14.86 ± 1.22 to 9.46 ± 1.10 m U / L, the difference was statistically significant(P <O.05);Group 3 decreased from 14.71 ± 1.14 to 8.93 ± 1.36 m U / L, the difference was statistically significant(P <O.05); fasting insulin(FINS) experienced a lift after the first procedure, which the Group 3 slightly significant. And at the same time point in the control group compared with the preoperative, GBP surgery group(2,3,4 group) after 1-3 weeks of insulin resistance index(HOMA-IR) decreased slightly, while decreased significantly to 12 weeks, group 2 HOMA-IR decreased from 9.97 ± 1.95 to 2.21 ± 0.38, the difference was statistically significant(P <O.05), group 3 HOMA-IR decreased from 9.98 ± 1.39 to 2.03 ± 0.23, the difference was statistically significant(P <O.05), wherein in the third group was significantly decreased slightly. And at the same time point in the control group compared with the preoperative, GBP surgery group(2,3,4 group) after GLP-1 levels have different rate increases, peaked at 12 weeks, Group 2 GLP-1 by increased 9.38 ± 1.88 to 18.96 ± 3.42, the difference was statistically significant(P <O.05); group 3 GLP-1 increased from 9.02 ± 2.20 to 23.23 ± 4.17, the difference was statistically significant(P <O. 05); wherein the third group to slightly significant.Conclusion: 1. retain full stomach, exclusion different sections of the small intestine gastric bypass procedure, and can significantly reduce fasting blood glucose and insulin resistance in non-obese diabetic rats and rats with body mass decrease has nothing to do.2 Advance into the terminal ileum after food, leading to the terminal ileum cells secrete glucagon-like peptide-1 increased, indicating that the increase in GLP-1 may be one of the reasons GBP T2 DM treatment.3.Best bit of the small intestine bypass effect area is in the middle of the small intestine, suggesting that surgical clinical GBP, the small intestine bypass effect best part may be the middle of the small intestine, the jejunum and ileum junction that is appropriate. |
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