摘要
减重手术是目前已知能够持久治疗肥胖症及其相关并发症的有效措施。减重手术类型包括限制摄入型、吸收不良型和混合型,通过改变胃肠道解剖结构,减重手术可达到限制食物摄入、减少食物吸收、增加饱腹感、延长胃排空的效果以降低患者体质量和调节代谢机制。减重手术可通过脑‑迷走神经‑味觉感受器的神经调节,使患者感觉特异性饱腹感,从而减少摄食;通过脑‑肠‑微生物轴即大脑、迷走神经、脊神经、肠神经系统的神经元通路以及信号通路,在维持体内平衡中发挥核心作用;通过脂肪因子、胆汁酸、激素等信号因子在体液调节中抑制高血压、糖尿病、非酒精性脂肪肝、心脑血管疾病的发展。因此,减重手术后代谢相关疾病的改善是神经、体液、微生物等多因素相互影响作用的结果。笔者回顾既往研究结果,探讨神经、体液因子调节在减重手术对体质量下降以及改善代谢相关疾病的机制。
Currently,bariatric surgery,which includes restricted intake,malabsorptive and mixed surgeries,is known to be an effective measurement for the durable treatment of obesity and related comorbidities.By changing the anatomy of gastrointestinal tract,bariatric surgery achieves the principles of restricting food intake,reducing food absorption,increasing satiety and prolonging gastric emptying to help patients lose weight and regulate metabolic mechanism.Through the neuromodulation of brain-vagus-taste receptors,sensation-specific satiety can reduce the food intake.The brain-gut-microbe axis plays a central role in maintaining homeostasis through neuronal pathways in the brain,vagus,spinal nerves,enteric nervous system and signaling pathways.Bariatric surgery can inhibit the development of hypertension,diabetes,non-alcoholic fatty liver,cardiovascular and cerebrovascular diseases in the regulation of body fluids through adipokines,bile acids,hormones and other signaling factors.Therefore,the improvement of metabolic-related diseases after bariatric surgery is the result of the interaction of multiple factors such as nerves,body fluids,and microorganisms.The authors summarize the literature reports to introduce the mechanism of neural and humoral factor regulation in weight loss and improvement of metabolic-related diseases after bariatric surgery.
作者
朱利勇
余芊芊
朱晒红
Zhu Liyong;Yu Qianqian;Zhu Shaihong(Department of Bariatric and Metabolic Surgery,the Third Xiangya Hospital of Central South University,Changsha 410013,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2022年第11期1422-1427,共6页
Chinese Journal of Digestive Surgery
基金
湖南省自然科学基金(2021JJ31039)。
关键词
肥胖症
减重手术
生理机制
神经调节
体液调节
Obesity
Bariatric surgery
Physiological mechanisms
Neuromodulation
Fluid regulation
