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在MASLD和2型糖尿病的管理中进行十二指肠粘膜干预
Zulqarnain Saeed1, Bojia Liu2, Muhammad Yousaf3
1Department of Hepatobiliary and Pancreatic Surgery and metabolic surgery, The Second Xiangya Hospital of Central South University, Changsha, 410008, Hunan, China.
Diabetology & metabolic syndrome
|January 15, 2026
概括
十二指甲膜粘膜切除程序,如DMR,显示治疗2型糖尿病 (T2DM) 和代谢功能障碍相关的脂肪性肝病 (MASLD) 的希望. 这些微创治疗方法可以改善血糖控制,减少肝脏脂肪,具有良好的安全性.
科学领域:
- 胃肠病学 胃肠病学
- 代谢医学是一种代谢医学.
- 内分泌学 在内分泌学.
背景情况:
- 肠肝轴功能障碍是代谢功能障碍相关的脂肪性肝病 (MASLD) 和2型糖尿病 (T2DM) 的基础.
- 至少侵入性的十二指甲膜粘膜切除程序旨在重置十二指甲膜信号,以改善代谢健康.
研究的目的:
- 系统地审查十二指甲粘膜治疗T2DM和MASLD的疗效和安全性.
- 评估这些程序对血糖控制,肝脂肪和胰岛素耐药性的影响.
主要方法:
- 2016年至2024年间发表的观察性研究和RCT的系统审查.
- 纳入标准侧重于接受十二指甲膜粘膜治疗的T2DM和/或MASLD的成年患者.
- 关键结局包括肝脂肪的变化,胰岛素耐药性,禁食血葡萄糖 (FPG),HbA1c和安全性.
主要成果:
- 十二指甲膜粘膜复苏 (DMR) 在假控制的RCT中显示肝脂肪和HbA1c显著降低.
- 在15项研究中,十二指甲膜粘膜切除程序 (包括DMR和通过电穿孔疗法重新细胞化 - ReCET) 安全降低了HbA1c,FPG和肝脂肪.
- 这些治疗导致86%的患者停止胰岛素治疗.
结论:
- 十二指甲膜粘膜治疗方法,特别是DMR,是T2DM和MASLD管理的可行,最小侵入性的选择.
- 虽然通常是安全和有益的,但对于MASLD患者的选择和疗效验证,需要进行进一步的组织学结果的长期研究.
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