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Nat Com:胆汁酸介导胃旁路减肥手术

摘要 : 本期Nature Communications上发表的一项研究报告说,将小鼠的胆汁向小肠的最后一段引流与胃旁路手术有可比的减肥效果。

 本期Nature Communications上发表的一项研究报告说,将小鼠的胆汁向小肠的最后一段引流与胃旁路手术有可比的减肥效果。

如“Roux-en-Y胃旁路手术”(RYGB)和“垂直袖状胃切除手术”等减肥手术是将部分胃切掉,或将一个较小的胃囊直接接到小肠上。对于人类来说,这些手术是获得持久减肥效果和逆转糖尿病症状的最有效干预措施。以前的研究表明,胆汁酸介导胃旁路手术的一些有益的代谢效应。

Naji Abumrad及同事将肥胖小鼠的胆囊接到小肠的不同部分,并在长达八个星期的一段时间内将该手术所产生的代谢好处与小鼠的RYGB手术直接进行比较。他们发现,将胆汁酸向小肠的最后一部分(回肠)引流,足以产生与更复杂的传统手术方法相似的减肥效果。作者提出,小肠中减少的脂肪吸收与肠道菌群的变化是产生这些效果的部分原因。

虽然胆汁引流与RYGB手术相比创伤较小,技术难度也较低,但作者谨慎指出,这种手术的长期安全性和效果还有待确定。另外,该方法对因胆结石问题摘除了胆囊的糖尿病或肥胖症患者可能无效,而且该手术可以逆转的程度目前也不清楚。

原文链接:

Bile diversion to the distal small intestine has comparable metabolic benefits to bariatric surgery

原文摘要:

Roux-en-Y gastric bypass (RYGB) is highly effective in reversing obesity and associated diabetes. Recent observations in humans suggest a contributing role of increased circulating bile acids in mediating such effects. Here we use a diet-induced obesity (DIO) mouse model and compare metabolic remission when bile flow is diverted through a gallbladder anastomosis to jejunum, ileum or duodenum (sham control). We find that only bile diversion to the ileum results in physiologic changes similar to RYGB, including sustained improvements in weight, glucose tolerance and hepatic steatosis despite differential effects on hepatic gene expression. Circulating free fatty acids and triglycerides decrease while bile acids increase, particularly conjugated tauro-β-muricholic acid, an FXR antagonist. Activity of the hepatic FXR/FGF15 signalling axis is reduced and associated with altered gut microbiota. Thus bile diversion, independent of surgical rearrangement of the gastrointestinal tract, imparts significant weight loss accompanied by improved glucose and lipid homeostasis that are hallmarks of RYGB.

来源: Nature Communications 浏览次数:0

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