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 research the changes of bile dynamics and plasma levels of cholecystokinin ( CCK ) and vasoactive intestinal peptide ( VIP ) in post-cholecystectomy patients. Methods Twenty-nine post-cholecystectomy patients were selected as observation group, including 14 patients combined with bile duct dilatation and 15 without bile duct dilatation. Another 17 healthy subjects were enrolled as the control group. They were assessed with quantitative 99mTc-EHIDA hepatobiliary scintigraphy to determine bile dynamics. Plasma levels of CCK and VIP were measured by enzyme-linked immunosorbent assay. Results Scintigraphic analysis demonstrated that the time to maximum counts and half excretion of liver were no significantly different among the three groups ( all P＞0. 05). The developing time of common hepatic duct, time of maximum counts of common bile duct, half excretion of common bile duct, developing time of duodenum, hepatic portal and duodenum transit time significantly increased in the bile duct dilatation group compared with those of the control group ( all P＜0. 05). Development time of duodenum, hepatic portal and duodenum transit time were significantly less in the non-bile duct dilatation group compared with those in the bile duct dilatation group and control group (all P＜0. 05). Fasting plasma levels of CCK and VIP were no significantly different among the three groups ( all P＞0. 05 ), while postprandial plasma levels of CCK and VIP were significantly higher in the bile duct dilatation group compared to those in the other two groups ( P＜0. 05). Conclusion After cholecystectomy, the flow and velocity of bile in bile duct and intestine increases during the interdigestive period for patients without bile duct dilatation, while for patients with bile duct dilatation, bile remains in common bile duct and is blocked from intestine, with gastrointestinal hormone regulation disorder.