肥胖小鼠Roux-en-Y胃旁路术后静息能量消耗和进食能量消耗均增加

Resting Energy Expenditure and Energetic Cost of Feeding Are Augmented after Roux-en-Y Gastric Bypass in Obese Mice.

肥胖小鼠Roux-en-Y胃旁路术后静息能量消耗和进食能量消耗均增加海南医学院附属医院内分泌科王新军

Although the prevalence of obesity has increased dramatically throughout the world during the last 25 yr, its long-term control remains poor. Currently, only gastrointestinal weight loss surgery, especially Roux-en-Y gastric bypass (RYGB), is associated with substantial and sustained weight loss and resolution or significant improvement of diabetes mellitus and other metabolic obesity-induced complications. Clinical observations and recent studies have suggested that RYGB induces its effects by changing the physiology of weight regulation.

在过去25年虽然世界各地肥胖患病率显著增加，但其长期控制仍然较差。目前，只有肠胃减肥手术尤其是Roux-EN-Y胃旁路（RYGB）手术可明确持续的减轻体重，治愈或显著改善糖尿病及其他代谢肥胖引起的并发症。临床观察和最近的研究表明，RYGB是通过改变体重调节的生理学而达到其治疗效果的。

Understanding the underlying mechanisms of these profound and sustainable effects could facilitate the development of novel and less invasive treatments against obesity and its complications. To study the physiological mechanisms of RYGB, we have developed a mouse RYGB model that replicates the human operation. The aims of this study were to develop a roadmap for assessing energy expenditure (EE) in animal models of weight loss surgery and to examine the effects of RYGB on EE. We first measured EE by indirect calorimetry in groups of animals that underwent RYGB or a sham operation. Calorimetry data were analyzed using three different methods: normalization by total body mass, allometric scaling, and analysis of covariance modeling. RYGB in mice induced a significant increase in EE that was independent of the method used. An energy balance analysis was then performed, which also confirmed that RYGB-treated animals have higher energy maintenance needs. Finally, we determined the EE components that account for the observed increase in EE, and we found that resting EE and postprandial thermogenesis are the major contributors to this increase.

了解这些显著和持续减肥效果的基本机制可以有助开发新的、创伤性更少的治疗肥胖及其并发症的方法。为探索RYGB的生理机制，作者建立了一种可模拟人类RYGB手术的小鼠模型。这项研究的目的是在动物模型中寻找一种评估减肥手术能量消耗（EE）的方法并观察RYGB对EE的影响。首先用间接侧热法测量接受RYGB或假手术小鼠的EE。使用三种不同的方法分析测得的热量数据：总体重正常化、类比法、协方差模型分析。无论使用何种方法，接受RYGB手术的小鼠EE显著增加。能量平衡分析也证实接受RYGB治疗的动物有更高的能量需求。观察EE组成部分发现这一增长的主要贡献是静息EE和餐后产热。