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首页> 外文期刊>Surgical Endoscopy >Improved insulin sensitivity after gastric bypass correlates with decreased total body fat, but not with changes in free fatty acids
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Improved insulin sensitivity after gastric bypass correlates with decreased total body fat, but not with changes in free fatty acids

机译：胃绕道手术后胰岛素敏感性的改善与体内总脂肪减少有关，但与游离脂肪酸的变化无关

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Background: Increased plasma free fatty acids (FFAs) are considered one of the key elements in the pathogenesis of insulin resistance (IR) and type 2 diabetes (T2DM). We hypothesize that, in diabetic patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB), a postoperative decrease in FFA will correlate with improved insulin sensitivity (Si). Methods: A total of 30 obese [body mass index ((BMI) 35 kg/m2] patients with a diagnosis of T2DM were studied preoperatively and 12 months after LRYGB in a prospective cohort study. Collected data included intravenous glucose tolerance test (IVGTT), total body composition by dual-energy X-ray absorptiometry and plasma levels of FFA. Si analysis from the IVGTT was estimated from minimal model analysis. Pre- and postoperative variables were compared using a paired sample t test. Relationships between changes in variables were determined with Pearson's correlation test. Results: Twelve months after LRYGB the study population showed a significant decrease in BMI (p = 0.001), FFA (p = 0.03), and total body fat (p = 0.03), with an increase in Si (p = 0.001). Postoperative changes in Si significantly correlated (Pearson's r = -0.53, p = 0.01) with change in total body fat, but not with changes in plasma FFA (Pearson's r = -0.22, p = 0.31). Conclusions: Our study challenges the notion that IR is mediated to a significant degree by changes in plasma FFA concentration. Instead, changes in adiposity and consequently changes in adipokine release can be the key players in determining remission of T2DM after LRYGB.
机译：背景：血浆游离脂肪酸（FFA）升高被认为是胰岛素抵抗（IR）和2型糖尿病（T2DM）发病机理中的关键因素之一。我们假设，在接受腹腔镜Roux-en-Y胃旁路手术（LRYGB）的糖尿病患者中，术后FFA降低将与胰岛素敏感性（Si）改善相关。方法：在一项前瞻性队列研究中，对术前和LRYGB治疗后12个月的30例肥胖[BMI> 35 kg / m2]肥胖患者进行了研究，收集的数据包括静脉葡萄糖耐量试验（IVGTT）。 ），双能X射线吸收法测定的人体总成分和血浆FFA含量，通过最小模型分析估算了IVGTT的Si分析，并使用配对样本t检验比较了术前和术后变量，变量之间的关系结果：在LRYGB后的12个月中，研究人群的BMI（p = 0.001），FFA（p = 0.03）和总体内脂肪（p = 0.03）显着下降，而Si增加（p = 0.001）。术后Si的变化与体内总脂肪的变化显着相关（Pearson's r = -0.53，p = 0.01），但与血浆FFA的变化却不相关（Pearson's r = -0.22，p = 0.31）。 ：我们的研究挑战了投资者关系的概念血浆FFA浓度的变化在很大程度上介导了β-内酰胺酶。取而代之的是，在确定LRYGB后T2DM的缓解方面，肥胖的变化以及随之而来的脂肪因子释放的变化可能是关键因素。

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