2型糖尿病患者胃转流术后游离脂肪酸的改变及其意义
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汤礼军 E-mail:whjtlj@yahoo.com.cn

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中国人民解放军全军临床高新技术重大项目资助(2010gxjs040)。


Changes of free fatty acid in type 2 diabetic patients after gastric bypass and its significance
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    摘要:

    目的:探讨2型糖尿病(T2DM)患者行胃转流术后血清游离脂肪酸(FFA)的变化及意义。
    方法:检测20例T2DM患者于手术前及手术后3个月和6个月时的血浆FFA,胰岛素抵抗指数(HOMA-IR)空腹血糖(FPG),餐后2小时血糖(PPG),糖化血红蛋白(HbA1C),体质量指数(BMI)等指标,并以20例健康人群做对照。
    结果:T2DM组15例完全缓解,3例部分缓解,2例无效。T2DM组术前FFA,HOMA-IR,FPG,PPG,HbA1C均显著高于健康对照组。T2DM组术后3~6个月FFA,HOMA-IR呈进行性下降,均显著低于术前(均P<0.01)。:FPG,PPG,HbA1C,BMI亦明显低于术前(均P<0.01)。T2DM组FFA与HOMA-IR在术前,术后3,6个月的相关系数分别为0.58(P<0.01),0.46(P<0.05),0.48(P<0.05)。
    结论:胃转流术能降低T2DM患者血清FFA,并由此减轻患者胰岛素抵抗,这可能是胃转流术治疗T2DM的作用机制之一。

    Abstract:

    Objective:To investigate the changes of free fatty acid in type 2 diabetic (T2DM) patients after gastric bypass surgery.
    Methods:The parameters including free fatty acid (FFA), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG), glycosylated hemoglobin (HbA1C), and body mass index (BMI) were measured in 20 patients with type 2 diabetes before, and 3 and 6 months after surgery, and 20 cases of healthy subjects were used as control.
    Results:Of the T2DM patients, 15 cases achieved complete remission, 3 cases obtained partial remission, and 2 cases had no remission. The values of FFA, HOMA-IR, FPG, PPG, and HbA1C of the T2DM patients were significantly higher than those of the healthy subjects before operation. The values of FFA and HOMA-IR in the T2DM patients decreased progressively from 3 to 6 months after surgery and all were significantly lower than those before operation (both P<0.01). FPG, PPG and HbA1C were all decreased significantly after surgery (all P<0.01). The correlation coefficients of FFA and HOMA-IR in the T2DM patients before, and 3 and 6 months after surgery were 0.58 (P<0.01), 0.46 (P<0.05) and 0.48 (P<0.05), respectively.
    Conclusions:Gastric bypass surgery can reduce the serum FFA level of T2DM patients and thereby lessen their insulin resistance. It may be one of the mechanisms of the therapeutic effect of gastric bypass on T2DM patients.

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石力| 汤礼军| 陈涛| 崔建峰| 李运明| 邹洪| 田伏洲.2型糖尿病患者胃转流术后游离脂肪酸的改变及其意义[J].中国普通外科杂志,2011,20(9):960-962.
DOI:10.7659/j. issn.1005-6947.2011.09.014

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  • 收稿日期:2011-03-03
  • 最后修改日期:2011-08-23
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  • 在线发布日期: 2011-09-15