發(fā)布時(shí)間：2018-06-12 03:00

  本文選題：肥胖癥 + Roux-en-Y胃旁路術(shù)��； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究Roux-en-Y胃旁路術(shù)(Roux-en-Y gastric bypass,RYGB)對肥胖癥大鼠糖代謝和腎臟糖異生的影響,初步探討胃旁路術(shù)后肥胖癥大鼠糖代謝和腎臟糖異生變化的原因,完善胃旁路術(shù)治療肥胖癥及其相關(guān)代謝紊亂的機(jī)制。方法:100只SD大鼠分別用高低脂飲食誘導(dǎo)構(gòu)建90只高脂肥胖癥大鼠和10只低脂對照大鼠,16周后將大鼠隨機(jī)分為4組:對照組(低脂飲食誘導(dǎo),n=8)、肥胖模型組(高脂飲食誘導(dǎo),n=8)、假手術(shù)組(假手術(shù)干預(yù)肥胖模型組,n=8)和手術(shù)組(胃旁路術(shù)干預(yù)肥胖模型組,n=8),術(shù)后8周處死大鼠留取血清及組織標(biāo)本。每周檢測體質(zhì)量及血糖值;術(shù)后血脂檢測試劑盒測定各組大鼠血清總膽固醇(TG)、甘油三酯(TC)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)的濃度;術(shù)后酶聯(lián)免疫吸附實(shí)驗(yàn)(ELASA)檢測血清胰高血糖素樣肽(GLP-1)和胰島素(FINS)濃度后計(jì)算穩(wěn)態(tài)模型的胰島素抵抗指數(shù)(HOMA-IR),術(shù)前術(shù)后各組大鼠分別行腹腔內(nèi)注射葡萄糖耐量實(shí)驗(yàn)(GTT)和腹腔內(nèi)注射胰島素耐量實(shí)驗(yàn)(ITT),梯形法計(jì)算血糖濃度-時(shí)間曲線下面積(AUG);術(shù)后骨密度儀(DEXA)成像、HE染色和免疫組化法分別觀察大鼠體脂肪分布、組織形態(tài)學(xué)變化和糖異生關(guān)鍵酶定位;術(shù)后實(shí)時(shí)熒光定量聚合酶鏈?zhǔn)椒磻?yīng)(RT-PCR)檢測各組大鼠腎皮質(zhì)糖異生關(guān)鍵酶,葡萄糖6磷酸酶(G6PC)和磷酸烯醇式丙酮酸羧激酶(PEPCK)m RNA的相對表達(dá)量;蛋白免疫印跡法(Western blot)檢測各組大鼠腎皮質(zhì)G6PC、PEPCK、IRS1和Akt及磷酸化蛋白的表達(dá)量。結(jié)果:1、體質(zhì)量及血糖變化:術(shù)前相較于對照組,肥胖模型組大鼠體質(zhì)量、血糖均明顯升高(P0.05);肥胖模型組大鼠空腹血糖、GTT和ITT2小時(shí)內(nèi)各時(shí)間點(diǎn)的血糖及AUG值較對照組明顯升高(P0.05)。術(shù)后相較于肥胖模型組及假手術(shù)組,手術(shù)組大鼠體質(zhì)量、血糖均明顯降低(P0.05);手術(shù)組大鼠空腹血糖、GTT和ITT2小時(shí)內(nèi)各時(shí)間點(diǎn)的血糖及AUG值較肥胖模型組及假手術(shù)組均明顯降低。(P0.05)2、血生化及病理變化:相較于肥胖模型組及假手術(shù)組,手術(shù)組大鼠血清總膽固醇、甘油三酯及低密度脂蛋白濃度均明顯降低(P0.05)。HE染色光鏡下顯示肥胖模型組和假手術(shù)組大鼠腎組織結(jié)構(gòu)異常。手術(shù)組大鼠的腎臟組織病理損傷明顯改善。相較于肥胖模型組及假手術(shù)組,手術(shù)組大鼠空腹血糖(FBG)、胰島素(FINS)和HOMA-IR值均明顯降低(P0.05),胰高血糖素樣肽(GLP-1)水平顯著升高(P0.05)。3、m RNA及蛋白表達(dá)水平相較于對照組,肥胖模型組及假手術(shù)組大鼠G6PC和PEPCK m RNA表達(dá)及蛋白含量均明顯升高(P0.05),p-IRS1和p-Akt蛋白含量均明顯降低(P0.05);手術(shù)組大鼠G6PC和PEPCK m RNA表達(dá)及蛋白含量較肥胖模型組及假手術(shù)組均明顯降低(P0.05),p-IRS1和p-Akt蛋白含量明顯升高(P0.05)。結(jié)論:1、高脂飲食誘導(dǎo)SD大鼠構(gòu)建的肥胖癥大鼠模型出現(xiàn)體質(zhì)量升高、血糖升高、體脂肪百分比增加、血脂代謝紊亂、糖耐量受損及胰島素抵抗,表現(xiàn)出肥胖癥及相關(guān)代謝性紊亂的特點(diǎn)。2、Roux-en-Y胃旁路術(shù)后顯著減輕肥胖癥大鼠體質(zhì)量、降低體脂肪百分比、改善血脂代謝紊亂和改善腎臟組織結(jié)構(gòu)異常病理改變。3、Roux-en-Y胃旁路術(shù)后肥胖癥大鼠血糖顯著減低、糖耐量明顯改善、胰島素敏感性增加和腎皮質(zhì)胰島素抵抗現(xiàn)象顯著緩解。胰島素通路因子表達(dá)升高,腎皮質(zhì)糖異生關(guān)鍵酶水平明顯減低,腎臟糖異生作用被削弱,腎臟的糖輸出減少,抑制內(nèi)源性葡萄糖的產(chǎn)生。胃旁路術(shù)后糖脂代謝的改善與此密不可分。
[Abstract]:Objective: To study the effects of Roux-en-Y Roux-en-Y gastric bypass (RYGB) on glucose metabolism and kidney isogenesis in obese rats. The causes of carbohydrate metabolism and renal glucose isogenesis in obese rats after gastric bypass were preliminarily investigated. The mechanism of gastric bypass surgery for obesity and its related metabolic disorders was perfected. Methods: 100 SD rats respectively. 90 high fat obesity rats and 10 low fat control rats were induced with high and low fat diet. After 16 weeks, the rats were randomly divided into 4 groups: control group (low fat diet induction, n=8), obesity model group (high fat diet induction, n=8), sham operation group (sham operation intervention obesity model group, n=8) and operation group (n=8), 8 after operation, 8 after operation. The body mass and blood glucose were measured weekly. The serum serum total cholesterol (TG), triglyceride (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) were measured by the blood lipid detection kit after the operation. The serum glucagon like peptide (GLP-1) was detected by enzyme linked immunosorbent assay (ELASA) after operation. After the insulin (FINS) concentration, the insulin resistance index (HOMA-IR) was calculated in the steady state model. The rats before and after the operation were injected intraperitoneally with glucose tolerance test (GTT) and intraperitoneal injection of insulin tolerance test (ITT), and trapezoid method was used to calculate the area of blood glucose under time curve (AUG); postoperative bone densitometer (DEXA) imaging, HE staining and exemption The distribution of body fat, the histomorphology and the key enzyme location of the glucose isoseme were observed by the immunofluorescence method, and the relative expression of glucose 6 phosphatase (G6PC) and phosphoenolpyruvate carboxylic kinase (PEPCK) m RNA were detected by real time fluorescence quantitative polymerase chain reaction (RT-PCR). Western blot was used to detect the expression of G6PC, PEPCK, IRS1, Akt and phosphorylated protein in the renal cortex of rats. Results: 1, body mass and blood glucose change: the body mass and blood sugar of the obese model group were significantly increased before the operation compared with the control group (P0.05); the blood glucose and A of the rats in the obese model group were empty, GTT and ITT2 hours. The UG value was significantly higher than that in the control group (P0.05). Compared with the obesity model group and the sham operation group, the body mass and blood sugar of the operation group were significantly decreased (P0.05). The blood glucose and AUG values at all time points in the operation group were significantly lower than those in the obesity model group and the sham operation group. (P0.05) 2, the blood biochemical and pathological changes were: Compared to the obesity model group and the sham operation group, the concentration of serum total cholesterol, triglyceride and low density lipoprotein in the operation group decreased significantly (P0.05).HE staining light microscope showed that the renal tissue structure of the obese and sham operated rats was abnormal. The pathological damage of the kidney in the operation group was obviously improved. In the sham operation group, the fasting blood glucose (FBG), insulin (FINS) and HOMA-IR were significantly decreased (P0.05), and the level of glucagon like peptide (GLP-1) increased significantly (P0.05).3, m RNA and protein expression level was compared with the control group. The expression and protein content of G6PC and PEPCK m in the obesity model group and the sham operation group increased significantly. The content of RS1 and p-Akt protein decreased significantly (P0.05), and the expression and protein content of G6PC and PEPCK m RNA in the operation group were significantly lower than those in the obese model group and the sham operation group (P0.05), and the content of p-IRS1 and p-Akt proteins increased significantly (P0.05). Conclusion: 1, the high fat diet induced the obesity rat model of rats induced by the high fat diet to increase the body mass and increase the blood sugar. High percentage of body fat, dyslipidemia, impaired glucose tolerance and insulin resistance, showing the characteristics of obesity and related metabolic disorders.2, Roux-en-Y after gastric bypass significantly alleviated the body mass of obese rats, reduced the percentage of body fat, improved blood lipid metabolism disorder and improved renal tissue structure abnormal pathological changes.3, Roux- After en-Y gastric bypass surgery, the blood sugar of the obese rats was significantly reduced, the glucose tolerance was obviously improved, the insulin sensitivity was increased and the renal cortical insulin resistance was significantly relieved. The expression of insulin pathway factor increased, the level of the key enzymes in the renal cortex decreased obviously, the renal isogenic effect was weakened, the kidney sugar output decreased and the endogenous Portuguese was inhibited. The production of fructose is closely related to the improvement of glucose and lipid metabolism after gastric bypass surgery.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R656.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 母松;劉佳雨;郭偉;張書平;汪志紅;張軍;;Roux-en-Y胃轉(zhuǎn)流術(shù)對肥胖大鼠肝臟糖原含量及Gsk-3β/Gs的影響[J];重慶醫(yī)科大學(xué)學(xué)報(bào);2016年06期

2 文藝;祁巧;馮犁;張少華;陳振宇;湯禮軍;;Roux-en-Y胃旁路術(shù)后對2型糖尿病大鼠腎臟胰島素受體表達(dá)的影響及意義[J];中國現(xiàn)代醫(yī)學(xué)雜志;2015年27期

3 本刊編輯部;俞美玲;趙湘;黃李春;俞敏;章榮華;;專家解讀《中國居民營養(yǎng)與慢性病狀況報(bào)告(2015)》[J];健康博覽;2015年08期

4 郭啟煜;;腎臟在血糖調(diào)節(jié)中的重要作用[J];藥品評價(jià);2014年09期

相關(guān)碩士學(xué)位論文 前1條

1 文藝;Roux-en-Y胃旁路術(shù)對2型糖尿病大鼠腎臟糖異生影響的實(shí)驗(yàn)研究[D];第三軍醫(yī)大學(xué);2014年

，

本文編號(hào)：2007984