减肥手术增强胰岛素敏感性

对两项减肥手术中使用的技术的研究显示：与胃改道术相比较，billopancreatic转移能够将患者胰岛素敏感性增加1倍。

超重患者面临学多医学问题，包括胰岛素抵抗以及2型糖尿病。对这些患者进行减肥手术使得体重下降，而胰岛素敏感性增加。在研究中，体重严重超标的18例非糖尿病患者与20例对照患者进行了代谢功能检测，包括测定胰岛素活性。肥胖患者接受胃改道手术（通过较小胃体积来限制食物摄入），或者Billopancreatic转移（缩短小肠减少脂肪吸收）。患者术后5～6月以及16～24月接受随访。

巴西Campinas州立大学(Sao Paulo, Brazil)Alza Muscelli医生解释说：“在当前的研究中，胃改道手术与Billopancreatic转移手术的生理学差异得到了探讨，突出了脂质吸收障碍与胰岛素活性支架的关系。但是，这些患者选择最佳治疗方案是根据风险/效益法则进行评估的。”

这项研究发表在2005年1月《美国医学期刊》 上。其它研究人员来自罗马Catholic大学以及Pisa大学。
 
Bariatric Technique Increases Insulin Sensitivity
 
A study of two techniques used in weight-loss surgery shows that billopancreatic diversion can double insulin sensitivity in patients, compared to gastric bypass surgery.

Excessively overweight patients can have many medical problems, including insulin resistance and often type 2 diabetes. Bariatric surgery for such patients leads to weight loss and improves insulin sensitivity. In the study, 18 nondiabetic patients with severe obesity and 20 lean subjects underwent metabolic studies, including the measurement of insulin activity. The obese patients then underwent either gastric bypass, which restricts food intake by making the stomach very small, or billopancreatic diversion, which shortens the small intestine and reduces fat absorption. Patients were followed at five to six months and again at 16-24 months after surgery.

“In the present study, the physiological difference between gastric bypass and billopancreatic diversion was exploited to highlight the link between lipid malabsorption and insulin action,” explained Alza Muscelli, M.D., of the State University of Campinas (Sao Paulo, Brazil). “However, the choice of the optimal therapeutic strategy in these patients depends on a risk/benefit algorithm to be assessed in each patient.”

The study was published in the January 2005 issue of The American Journal of Medicine. Other researchers from the Catholic University in Rome (Italy) and the University of Pisa (Italy) also participated in the study.