Department of Gastrointestinal Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, No.57 Mei Hua East Road, Xiang Zhou District, Zhuhai, 519000, Guangdong, China.
Department of General Surgery, The First People's Hospital of Kashi, Autonomous Region, Kashi, 844000, Xinjiang Uygur, China.
Obes Surg. 2024 Aug;34(8):3071-3083. doi: 10.1007/s11695-024-07378-z. Epub 2024 Jul 1.
In recent years, there has been a gradual increase in the prevalence of obesity and type 2 diabetes mellitus (T2DM), with bariatric surgery remaining the most effective treatment strategy for these conditions. Vertical sleeve gastrectomy (VSG) has emerged as the most popular surgical procedure for bariatric/metabolic surgeries, effectively promoting weight loss and improving or curing T2DM. The alterations in the gastrointestinal tract following VSG may improve insulin secretion and resistance by increasing incretin secretion (especially GLP-1), modifying the gut microbiota composition, and through mechanisms dependent on weight loss. This review focuses on the potential mechanisms through which the enhanced action of incretin and metabolic changes in the digestive system after VSG may contribute to the remission of T2DM.
近年来,肥胖症和 2 型糖尿病(T2DM)的患病率逐渐增加,减重手术仍然是这些疾病最有效的治疗策略。胃袖状切除术(VSG)已成为减重/代谢手术中最受欢迎的手术程序,有效地促进了体重减轻,并改善或治愈了 T2DM。VSG 后胃肠道的改变可能通过增加肠促胰岛素(特别是 GLP-1)的分泌、改变肠道微生物群落组成以及通过依赖体重减轻的机制来改善胰岛素分泌和抵抗。本综述重点介绍了 VSG 后消化系统中肠促胰岛素作用增强和代谢变化可能有助于 T2DM 缓解的潜在机制。