ABSTRACT
Objective To explore the influence of modified radical gastrectomy on glycometabolism in patients with gastric carcinoma and non-obese T2DM.Methods The retrospective study was carried out to analyze the changes of glycometabolism between preoperative and postoperative follow-up in 25 patients with gastric carcinoma and non-obese T2DM.The above parameters included fasting plasma glucose (FPG),2-hour postprandial blood glucose (2 h PBG),glycosylated hemoglobin A1c (HbA1c),fasting insulin (FINS),homeostasis model assessment-insulin resistance (HOMA-IR),fasting glucagon-like peptide-1 (GLP-1),and glucose-dependent insulinotropic polypeptide (GIP).Results At the 6th and 12th month after operation,the related parameters such as FPG,2 h PBG,HbA1c,FINS and HOMA-IR were (7.54±1.44) mmo]/L and (7.17±1.35) mmol/L,(9.97±1.59)mmol/L and (9.47±1.23) mmol/L,(6.46±0.74)％ and (6.31±0.97)％,(7.73±0.98) μIU/ml and (7.44±0.96) μIU/ml,1.10±0.15 and 1.04±0.14 respectively.The above indexes were significantly improved compared with those before operation (P＜O.05).The levels of fasting GLP-1 at 6th and 12th month after operation were (2.27±0.25) pmol/ml and (2.33±0.27) pmol/ml respectively,and there was no significant change compared with those before operation (P＞0.05).On the contrary,the levels of GIP at 6th and 12th month after operation are significantly decreased compared with that before operation,which were (7.23±1.33) pmol/ml and (6.40±1.20) pmol/ml respectively.Conclusion The modified radical gastrectomy can improve T2DM in patients with gastric carcinoma markedly,even curing some patients,which may be related to the decrease of fasting GIP after operation.
ABSTRACT
Objective To evaluate the different effects of gastric banding (GB) and sleeve gastrectomy (SG) on diet-induced obese rat model.Methods The obese rat model was established via the diet-induced method,and then underwent SG,GB,or sham-operation (SO) procedures.The different effects of SG,GB,and SO on these rats were evaluated at the 14th,28th and 56th day after operation.Results After 7 weeks' feeding,31rats in high-diet group reached the modeling standard.The model success rate was 88.6％ (31/35).GB and SG group showed significantly less cumulative food intake than SO group ( P ＜ 0.01).There was no significant difference between GB and SG group in cumulative food intake ( P ＞ 0.05 ).The average weight of rats in GB and SG group was (609.1±6.0) g and (591.6 ±4.3) g respectively at the 56th day after operation while it was (649.8 ± 10.0) g for SO group.The difference had statistical significance ( P ＜ 0.01).SG group showed better improvement effects on TC,TG,FFA,LDL-c and HDL-c than GB group (P ＜0.05).The postoperative ghrelin level in GB and SG group all decreased constantly and it decreased slower in GB group than in SG group.At the 56th day after operation,the ghrelin level in GB and SG group reduced from (1151.0 ± 144.2) pg/ml and (1148.2±127.2) pg,/ml to (992.0+121.9) pg/ml (P＜0.05) and (761.0+125.3) pg/ml (P＜0.01) respectively.The leptin level in GB and SG group all showed decreasing tendency.However,the leptin level of the 2 groups presented significant difference at the 56th day after operation.Conclusions There is no significant difference between GB and SG group in postoperative cumulative food intake.However,SG has better effects on controlling weight gain and improving blood lipids than GB.The different effects of GB and SG on the level of ghrelin and leptin in rats may account for the different curative effects.