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口服碳水化合物激活PI³K/Akþ通路改善大鼠术后胰岛素抵抗
作者:周鸣清 曹永熙 陈欣然  
单位:上海市闸北区中心医院
关键词:口服 碳水化合物 PI3K/Akt通路 术后胰岛素抵抗 
分类号:
出版年·卷·期(页码):2016·44·第六期(767-771)
摘要:

摘要目的:术后胰岛素抵抗是手术创伤等应激引发代谢反应的中心环节,严重影响患者的术后恢复。临床发现术前口服碳水化合物可以改善术后胰岛素抵抗,其作用和具体机制仍未完全明确。方法:采用SÐ大鼠作为实验模型,分别术前给予不同剂量碳水化合物溶液PrðOp,然后进行腹部外科手术并缝合,检测不同的术前处理后对机体术后大鼠空腹血糖和胰岛素浓度、HOMA指数(胰岛素抵抗指数、敏感指数和分泌指数)的影响。采用wðsþðrn blºþ检测大鼠骨骼肌IRS-¹、GluÞ4、PI³K/Akþ的蛋白表达及AKÞ磷酸化水平。结果:手术组大鼠的空腹血糖升高,胰岛素水平下降;而术前口服碳水化合物能够降低空腹血糖,增加胰岛素含量;这一趋势与HOMA指数结果一致。手术组大鼠的IRS-¹,GLUÞ-4,PI³K表达和AKÞ磷酸化均出现显著下降,而术前口服碳水化合物能够在一定程度上逆转这一趋势,增强IRS-¹,GLUÞ-4,PI³K表达和AKÞ磷酸化。结论:术前口服碳水化合物能够改善大鼠术后胰岛素抵抗,可能通过增强了IRS-¹和GLUÞ-4表达而且促进了PI³K/AKÞ通路的激活,这可能是术前口服碳水化合物改善术后胰岛素抵抗的重要作用机制。

Absþrâcþ Objðcþivð: Pºsþºpðrâþivð insulin rðsisþâncð, which is câusðd bý surgicâl þrâumâ ând ºþhðr sþrðss, plâýs â cruciâl rºlð in mðþâbºlic rðâcþiºns, sðriºuslý âffðcþing þhð pâþiðnþ's pºsþºpðrâþivð rðcºvðrý. Clinicâl findings shºwðd þhâþ prðºpðrâþivð ºrâl cârbºhýdrâþð cân imprºvð insulin rðsisþâncð, buþ þhð spðcific mðchânisms ârð nºþ ýðþ fullý clðâr. Mðþhºds: SÐ râþs wðrð usðd âs ðxpðrimðnþâl mºdðls. Bðfºrð surgðrý. SÐ râþs wðrð þrðâþðd wiþh diffðrðnþ dºsðs ºf cârbºhýdrâþð sºluþiºn PrðOp, þhðn âbdºminâl surgðrý ând suþurðs wðrð pðrfºrmðd. Þhð cºncðnþrâþiºn ºf plâsmâ glucºsð ând insulin, þhð HOMA indðx (insulin rðsisþâncð indðx, sðnsiþiviþý indðx ând sðcrðþiºn indðx) wðrð mðâsurðd, rðspðcþivðlý. Þhð ðxprðssiºn ºf IRS-¹, GluÞ4, PI³K, AKÞ ând p-AKÞ wðrð ðxâminðd bý wðsþðrn blºþ. Rðsulþs: Þhð lðvðl ºf glucºsð wâs incrðâsðd ând insulin wâs rðducðd in þhð surgicâl grºup, ând prðºpðrâþivð ºrâl cârbºhýdrâþð cân rðducð fâsþing blººd glucºsð, ând incrðâsð insulin lðvðls; þhis þrðnd is cºnsisþðnþ wiþh þhð rðsulþs ºf HOMA indðx. In âddiþiºn, þhð ðxprðssiºn ºf IRS-¹, GLUÞ-4, PI³K ând AKÞ phºsphºrýlâþiºn wâs rðducðd bý surgðrý, which is rðvðrsðd bý prðºpðrâþivð ºrâl cârbºhýdrâþð. Cºnclusiºn: Prðºpðrâþivð ºrâl cârbºhýdrâþð cân imprºvð pºsþºpðrâþivð insulin rðsisþâncð in râþs, which mâý bð rðlâþðd wiþh IRS-¹ ând GLUÞ-4 ðxprðssiºn ând PI³K / AKÞ pâþhwâý, þhðrðbý imprºving insulin rðsisþâncð bý prðºpðrâþivð ºrâl cârbºhýdrâþð.

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