Repercussões metabólicas e alterações morfológicas do pâncreas endócrino após interposição ileal isolada em ratos normoglicêmicos
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Data
2012-12-20
Autores
Cardia, Wellington [UNIFESP]
Orientadores
Azevedo, João Luiz Moreira Coutinho [UNIFESP]
Tipo
Tese de doutorado
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Introdução: Fatores neurohormonais e metabólicos associados aos procedimentos bariátricos são o foco no tratamento cirúrgico do diabetes mellitus tipo 2 (DM2), com efeitos sobre a produção de insulina e no metabolismo glicídico e lipídico. Apesar de níveis glicêmicos mais baixos após
Interposição Ileal Isolada (III), em ratos euglicêmicos, as alterações morfológicas do pâncreas não foram estudadas. O objetivo deste estudo foi avaliar os efeitos ponderais, metabólicos e na morfologia pancreática após III. Métodos: Estudo experimental com 24 ratos machos adultos Wistar, normais, distribuídos no Grupo Interposição (GI), submetidos a III e no grupo Simulado (GS), submetidos à operação simulada. Foram mensurados a massa corporal e o consumo alimentar da 13a a 21a semana de vida, 8 semanas de pós-operatório(PO), quando foi realizada a eutanásia. Parâmetros bioquímicos e o teste de tolerância insulínica (ITT) foram mensurados antes da cirurgia e na eutanásia. Foram efetuadas as medidas de tecido pancreático e de ilhotas de Langerhans, além da contagem de células beta e não marcadas por imunohistoquímica. Resultados: Não houve diferença entre os grupos na evolução da massa corporal, no consumo alimentar, nas dosagens bioquímicas e no ITT. Na análise dos momentos em cada grupo, na eutanásia, o GI apresentou níveis mais elevados de insulinemia (p=0,01) e HDL-colesterolemia (p<0,01) e colesterolemia total mais baixa (p=0,04), enquanto o GS apresentou glicemia (p=0,01) e trigliceridemia (p<0,01) mais elevadas. O ITT não apresentou diferença. Observou-se resultados semelhantes para os dois grupos na relação entre a área de ilhotas e área de pâncreas (p=0,37), na relação do número de células beta por área de ilhota (p=0,18) e área de pâncreas (p=0,47) e no percentual de células beta (p=0,38). Discussão: Não foi demonstrado que a III tem efeitos adversos sobre a morfologia do pâncreas endócrino e foi benéfico para o metabolismo glicídico e lipídico. Conclusão: Em ratos normais, a interposição ileal não influencia na população de células beta e induz alterações benéficas no metabolismo da glicose e lipídios. Assim, a III poderia representar uma técnica operatória para o tratamento de DM2 em pacientes com IMC normal.
Introduction: Neurohormonal and metabolic factors associated with bariatric procedures are a focus in the surgical treatment of diabetes mellitus type 2 (DM2), with effects on insulin production and metabolism of glucose. Although there was improvement in glucose tolerance in euglycemic rats after Isolated Ileal Interposition (III), morphology of the pancreas have not been studied. The objective of this study was to evaluate the III effects on weight, food intake, metabolism and morphology of pancreas. Methods: Experimental study with 24 normal adult male Wistar rats distributed in interposition group (IG), submitted to III and in sham group (SG), submitted to simulado operation. It was measured the body weight and the food intake, weekly, from 13th to 21st week of life, 8 weeks postoperatively (PO), where euthanasia was performed. Fasting biochemical measurements and insulin tolerance test (ITT) were performed before surgery and euthanasia. It was measured area of pancreas and islets of Langerhans, in addition to beta-cell and not marked cell count, by immunohistochemistry. Results: There was no differences between groups in the evolution of body weight, food intake, on the biochemical and ITT. In the analysis of moments in each group, in euthanasia, the IG presented higher insulin (p=0.01) and HDL-chlesterolemia (p<0,01) and lower cholesterol (p=0.04), while GS showed blood glucose (p=0.01) and triglycerides (p<0,01) higher. The ITT showed no differences. There was similar results for both groups concerning the ratio between the area of islets and the area of the pancreas (p=0.37), in the ratio of the number of beta cells and islet area (p=0.18), and pancreas area (p=0.47) and the percentage of beta cells (p=0.38). Discussion: This study showed that III has no adverse effect on the morphology of the endocrine pancreas, and is beneficial for the glicid and lipid metabolism, in normal rats. Conclusion: In normal rats, the ileal interposition does not influence the beta cell population and induces beneficial changes in glucose metabolism and lipids. Thus, the isolated ileum interposition could represent a surgical technique to treat type 2 diabetes in patients with normal BMI.
Introduction: Neurohormonal and metabolic factors associated with bariatric procedures are a focus in the surgical treatment of diabetes mellitus type 2 (DM2), with effects on insulin production and metabolism of glucose. Although there was improvement in glucose tolerance in euglycemic rats after Isolated Ileal Interposition (III), morphology of the pancreas have not been studied. The objective of this study was to evaluate the III effects on weight, food intake, metabolism and morphology of pancreas. Methods: Experimental study with 24 normal adult male Wistar rats distributed in interposition group (IG), submitted to III and in sham group (SG), submitted to simulado operation. It was measured the body weight and the food intake, weekly, from 13th to 21st week of life, 8 weeks postoperatively (PO), where euthanasia was performed. Fasting biochemical measurements and insulin tolerance test (ITT) were performed before surgery and euthanasia. It was measured area of pancreas and islets of Langerhans, in addition to beta-cell and not marked cell count, by immunohistochemistry. Results: There was no differences between groups in the evolution of body weight, food intake, on the biochemical and ITT. In the analysis of moments in each group, in euthanasia, the IG presented higher insulin (p=0.01) and HDL-chlesterolemia (p<0,01) and lower cholesterol (p=0.04), while GS showed blood glucose (p=0.01) and triglycerides (p<0,01) higher. The ITT showed no differences. There was similar results for both groups concerning the ratio between the area of islets and the area of the pancreas (p=0.37), in the ratio of the number of beta cells and islet area (p=0.18), and pancreas area (p=0.47) and the percentage of beta cells (p=0.38). Discussion: This study showed that III has no adverse effect on the morphology of the endocrine pancreas, and is beneficial for the glicid and lipid metabolism, in normal rats. Conclusion: In normal rats, the ileal interposition does not influence the beta cell population and induces beneficial changes in glucose metabolism and lipids. Thus, the isolated ileum interposition could represent a surgical technique to treat type 2 diabetes in patients with normal BMI.
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Citação
CARDIA, Wellington. Repercussões metabólicas e alterações morfológicas do pâncreas endócrino após interposição ileal isolada em ratos normoglicêmicos. São Paulo, 2012. 94 f. Tese (Doutorado em Medicina Translacional) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2012.