病后低血糖症:对一顿饭的代谢反应受损
Ömrüm Aydin1, Abraham S Meijnikman1, Patrick A de Jonge1
1Department of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
腹后低血糖症 (PBH) 影响了Roux-en-Y胃绕道术 (RYGB) 后33%的患者. 在PBH患者中,代谢学揭示了改变的卡尼丁和乙烯胆,这表明它在能量代谢中发挥了作用.
科学领域:
- 内分泌学 在内分泌学.
- 代谢学 代谢学 代谢学
- 腹部外科 腹部外科
背景情况:
- 腹后低血糖症 (PBH) 是腹手术后腹后高胰岛素血症的结果.
- 对于PBH监管和补偿系统故障的确切机制尚不清楚.
研究的目的:
- 调查带有PBH和没有PBH的患者之间的食后激素和代谢概况的差异.
- 确定潜在的生物标志物和参与PBH发展的代谢途径.
主要方法:
- 在Roux-en-Y胃旁路手术 (RYGB) 之前和1年后,对63名受试者进行了混合食测试 (MMT).
- 血中葡萄糖,胰岛素,GLP-1,FGF-19和FGF-21的水平被测量在时间间隔.
- 进行了非向的代谢分析,以确定改变的代谢概况.
主要成果:
- 33%的受试者在RYGB后的一年内发展出PBH (葡萄糖<3.1 mmol/L).
- 在MMT期间,PBH患者表现出降低的葡萄糖和增加的胰岛素外流.
- 虽然手术后GLP-1,FGF-19和FGF-21的水平升高,但PBH和非PBH组之间没有差异.
- 代谢学发现了20种代谢物,包括增加的卡尼丁和乙胆,这些代谢物在各组之间存在差异.
结论:
- 在RYGB的一年内,PBH会影响三分之一的患者.
- 在这两组中,荷尔蒙特征 (GLP-1,FGF-19,FGF-21) 是相似的.
- 在PBH患者中改变的肉丁和乙胆可能与能量代谢和PBH病原发生有关.
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