The Effect of Bariatric Surgery on Carbohydrate Metabolism

减肥手术对碳水化合物代谢的影响

基本信息

批准号：
8453466
负责人：
Adrian Vella
金额：
$ 28.84万
依托单位：
MAYO CLINIC ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-03 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8453466
关键词：
Abbreviations Address Affect Amides Animals Antidiabetic Drugs Appearance Bariatrics Body Weight decreased Bypass C-Peptide Caloric Restriction Calories Cholecystokinin Clinic Clinical Research Denervation Development Diabetes Mellitus Diet Dipeptidyl Peptidases Disease remission Distal Double-Blind Method Duodenum Effectiveness Energy Intake Enteric Nervous System Enteroendocrine Cell Gastrectomy Gastric Bypass Gastric Emptying Gastrointestinal Motility Gastrointestinal Transit Gastroparesis Glucagon Glucose Hepatic Hormonal Hormones Hour Human Hunger Hyperglycemia Hyperinsulinism Impaired fasting glycaemia Individual Ingestion Insulin Insulin Resistance Intestinal Bypasses Intestinal Hormones Intestinal Secretions Intestines Intravenous L Cells Lead Malabsorption Syndromes Measurement Measures Metabolic Methodology Modeling Nerve Non-Insulin-Dependent Diabetes Mellitus Nutrient Obesity Operative Surgical Procedures Oral Organ Pancreas Patients Peptide YY Peripheral Physiology Placebo Control Postoperative Period Preventive Intervention Procedures Qualitative Methods Research Resolution Respiratory Diaphragm Rodent Satiation Signal Transduction Small Intestines Stomach Suggestion System Techniques Testing Time Tracer absorption bariatric surgery blood glucose regulation carbohydrate metabolism design dietary restriction fasting glucose gastric inhibitory polypeptide receptor glucagon-like peptide glucose disposal glucose metabolism glucose production glucose tolerance glucose uptake glycemic control ileum improved incretin hormone indexing insulin secretagogues insulin secretion intervention effect intravenous glucose tolerance test jejunum member novel public health relevance receptor treatment strategy tyrosyltyrosine uptake

项目摘要

DESCRIPTION (provided by applicant): The overall aim of this application is to determine the mechanism(s) by which common bariatric surgical procedures alter carbohydrate metabolism. Very often, resolution of diabetes occurs in the early post-operative period prior to the development of significant weight loss. It has been suggested that bariatric surgery alters insulin action but few studies have examined insulin secretion or postprandial glucose fluxes in such patients. Recently, it has been shown that bypass of relatively short segments of the intestine are associated with remission of type 2 diabetes reinforcing the suggestion that hormonal signals from the excluded proximal gut favorably alter glucose metabolism. Another possibility is that enhanced distal intestinal delivery of nutrients stimulates hypersecretion of known or unknown hormones produced by the enteroendocrine system which ameliorate diabetes. Postprandial glucose tolerance is the net result of insulin secretion and action, intestinal uptake and splanchnic extraction, peripheral glucose uptake and suppression of endogenous glucose production. At the present time, little is known about how the various bariatric surgical procedures alter glucose homeostasis. It is essential that the effect of bariatric surgery and meal size on these parameters be understood and accurately measured. Enteroendocrine secretion is affected by the rate of intestinal delivery of calories and may also be modulated by the enteric nervous system and the rate of direct delivery of nutrients to enteroendocrine cells. Direct measurement of intestinal transit is also an important part of understanding how bariatric surgery alters intestinal secretion of hormones that may alter glucose metabolism.

描述（由申请人提供）：本申请的总体目标是确定常见减肥手术改变碳水化合物代谢的机制。通常，糖尿病的消退发生在术后早期，在体重明显减轻之前。有人建议减肥手术会改变胰岛素的作用，但很少有研究检查此类患者的胰岛素分泌或餐后葡萄糖通量。最近，研究表明，相对较短的肠道段的绕道与 2 型糖尿病的缓解相关，这进一步证明了来自被排除的近端肠道的激素信号有利于改变葡萄糖代谢的观点。另一种可能性是，增强的远端肠道营养输送会刺激肠内分泌系统产生的已知或未知激素的过度分泌，从而改善糖尿病。餐后葡萄糖耐量是胰岛素分泌和作用、肠道摄取和内脏提取、外周葡萄糖摄取和内源性葡萄糖产生抑制的最终结果。目前，人们对各种减肥手术如何改变血糖稳态知之甚少。了解并准确测量减肥手术和膳食量对这些参数的影响至关重要。肠内分泌分泌受肠道热量输送速率的影响，也可能受到肠神经系统和营养物质直接输送至肠内分泌细胞的速率的调节。直接测量肠道运输也是了解减肥手术如何改变肠道激素分泌的重要部分，而激素分泌可能会改变葡萄糖代谢。