LUB SIJ HAWM MICROBIOME HAUJ LWM HAUJ LWM HAUJ LWM HAUV BARIATRIC SurgeRY: A SYSTEMATIC REVIEW Ⅲ

Cov txheej txheem bariatric cov txheej txheem suav nrog VG lossis gastricsleeve, gastric RYGB, thiab BPD. SG cuam tshuam txog kev tshem tawm kwv yees li 75-80% ntawm lub plab, tawm hauv lub hnab me me zoo li lub hnab.RYGB yuav tsim lub hnab me me, feem ntau yog li 30 ml hauv ntim, thiab gastrojejunostomy ntawm lub hnab jejunum. Cov khoom noj uas tau noj hla dhau li ntawm 95% ntawm lub plab, tag nrho duodenum, thiab ib feem ntawm lub jejunum. BPD yog ib txoj kev tsis sib haum xeeb uas muaj kev cuam tshuam nrog subtotalgastrectomy ntxiv rau lub plab zom mov ntev nrog kev sib xyaw ntawm bileand as-ham2.

Nyem rau natural laxatives

Kev phais Bariatric tau pom zoo los ntawm cov kws paub txog qhov hnyav rau cov tib neeg uas muaj BMI ntawm 40 lossis 35 kg / m² nrog kev sib koom ua ke. Txhua txoj kev phais bariatric ua rau txo qis hauv cov zaub mov kom tsawg thiab caloriesconsumed15. Ntxiv nrog rau kev hloov pauv ntawm lub cev, ntau tus neeg mob muaj qhov tshwm sim ua ntej uas cuam tshuam cov txiaj ntsig tom qab kev phais, xws li plab microbiota, hloov pauv kev phais, thiab AT. Nrog rau kev hloov pauv ntawm lub plab zom mov, qhov ceev ntawm cov zaub mov hloov ntawm lub plab mus rau ileum hloov, thiab ob qho tib si RYGB thiabVG txo cov teebmeem ntawm gastric acid ntawm cov zaub mov noj2,16.Cov kev hloov no yog sib txawv raws li kev phais kev xaiv. Feem ntau, qhov poob phaus loj tshaj plaws tshwm sim tom qab RYGB, nrog rau feem pua ​​​​ntawm kwv yees li 62.58% ntawm 5 xyoo thiab 63.52% ntawm 10 xyoo 7,16.

Thawj txoj kev tshawb fawb ntawm microbiota tom qab kev phais mob bariatric tshwm sim hauv xyoo 2009, uas suav nrog cov ntaub ntawv los ntawm peb tus neeg rog rog, peb tus neeg tom qab plab zom mov, thiab peb nrog qhov hnyav, thiab tau sau tseg tias muaj ntau ntawm H2-H2- ua cov kab mob. Nyob rau hauv tib lub xyoo, lwm txoj kev tshawb fawb tau ua ua ke nrog thawj longitudinal tsom xam ntawm lub plab microbiota ntawm 30 obeseindividuals undergoing gastric bypass. Cov txiaj ntsig tau pom tias muaj qhov qis dua Bacteroidetes / Prevotella piv ua ntej kev phais thiab ntau dua Bacteroidetes / Prevotella piv tom qab kev phais17.Hauv kev tshuaj xyuas cov ntaub ntawv, Debédat li al., hauv 2019, pom tau tias cov hnyuv yog ib qho khoom yas thiab tshwj xeeb rau kev phais loj ntawm kev tshem tawm. cov ileum uas ua rau muaj kev loj hlob ntawm cov hlwb, yog li ua kom cov piam thaj uptake thiab siv.

Cov hlwb secretory kuj nce ntxiv, ua rau muaj kev tsim cov tshuaj hormones hauv plab hnyuv xws li glucagon-derivedpeptide (GLP-2). Postprandial GLP-1 tso zis ntau ntxiv, uas tuaj yeem ua rau kev txhim kho insulin secretion. GLP-2, sib koom nrog GLP-1 hauv plab hnyuv L hlwb thiab tso tawm tom qab noj zaub mov, muaj lub luag haujlwm zoo trophic nyob rau hauv txoj hnyuv nrog stimulation ntawm crypt cell proliferation, nce plab hnyuv hnyav, thiab villus loj hlob nyob rau hauv ob qho tib si jejunum thiab cov hnyuv me2,6-8,16.Thaum tshawb nrhiav cov kab mob metabolomic txuas nrog cov metabolites uas tuaj yeem cuam tshuam los ntawm kev phais bariatric, kev phais phais txo qis tricarboxylic acid voj voog, glycine, serine, thiab threonine metabolism, glyoxylate thiab dicarboxylate, thiab tyrosine metabolism. Cov txiaj ntsig no qhia tias BCAAs andaromatics, nrog rau cov metabolism hauv lub zog, raug tswj tsis zoo nrog kev phais bariatric18. Txawm hais tias muaj txiaj ntsig zoo ntawm BCAA supplementation tau piav qhia, qee qhov kev tshawb fawb pom tau tias nce qib BCAA hauv kev rog thiab cov neeg hauv cov tshuaj insulin tsis kam 8,11,21.

Cov txheej txheem RYGB induces ib tug txo nyob rau hauv cov ntshav BCAAs, ntxiv validating yuav ua li cas bariatric phais aidsin insulin kuj thiab qabzib metabolism. BCAA qib txo qis tsuas yog hauv cov neeg mob uas poob tsawg kawg 10 kg ntawm lub cev qhov hnyav tom qab kev phais bariatric, tab sis tsis yog nyob rau hauv cov neeg mob uas zoo sib xws yuag poob vim los ntawm kev txwv tsis pub noj, qhia txog lub luag haujlwm ntawm bariatric phais-dependent mechanism hauv BCAAreduction6. Cov txheej txheem VG tshwj xeeb tau pom tias muaj peev xwm nce ntxiv rau amino acid biosynthesis tom qab kev phais, amechanism uas tuaj yeem txuas rau kev txhim kho cov piam thaj 6,11.Qee cov neeg mob uas tau txais kev phais bariatric tau tshaj tawm cov kev txhim kho hauv cov kab mob metabolic, suav nrog txo lub duav ncig, txo triglycerides, txo cov piam thaj ntau ntxiv, high-density lipoprotein, thiab txo cov ntshav siab. Ntau qhov kev piav qhia rau qhov kev hloov pauv ingut architecture yog vim kev hloov pauv khoom noj khoom haus, hormonalmodification, bile acids (BAs), thiab kev hloov pauv hauv qib 5,8,17.

Qee qhov ntawm cov no tau cuam tshuam nrog cov kab mob metabolicsyndrome thiab nce Veillonella, uas yog sib cuam tshuam nrog lub duav ncig thiab cuam tshuam zoo nrog feem pua ​​​​ntawm qhov hnyav. Escherichia, Akkermansia, Enterococcus, thiab Carnobacterium zoo sib raug zoo nrog feem pua ​​​​yuav poob, thiab Bifidobacterium thiab Sutterella tsis zoo correlated5,20,26.Tsis ntev los no, ib qho kev tshuaj ntsuam meta los ntawm Guo li al. qhia txog kev hloov pauv hauv ob hom, Escherichia thiab Akkermansia, tom qab kev phais mob phais. Kev hloov pauv hauv cov kab mob genera, xws li Eubacteriumspp., Ruminococcaceae spp., thiab Faecalibacterium spp., thaj chaw cuam tshuam nrog kev txhim kho hauv cov txheej txheem metabolic, suav nrog HbA1c. Tsis tas li ntawd, kev noj zaub mov kom zoo tom qab kev phais mob bariatric kuj tseem tuaj yeem ua lub luag haujlwm hauv kev nce MGR, piv txwv li kev rog dhau, uas nws cov microbiota nplua nuj tau txo qis 10,16.

Fusobacteriaceae, Clostridiaceae, thiab Enterobacteriaceaespecies tau nce ntau, thaum Bifidobacteriaceae thiab Peptostreptococcaceae txo qis hauv kev nplua nuj tom qab RYGB.Tam sim no, muaj kev nce hauv microbiota nplua nuj, feem ntau yog vim Proteobacteria, nrog kev sib koom ua ke ntawm cov kab mob hauv plab thiab cov kab mob dawb. phyla tau cuam tshuam nrog txhim kho pob tw rog rog thiab glycated hemoglobin6,19. Tsis tas li ntawd, RYGB pom tau tias muaj kev nce ntxiv ntawm cov kab mob hauv qhov ncauj xws li Fusobacteria, Veillonella, thiab Granulicatella, thiab cov kev hloov pauv no tuaj yeem tshwm sim vim pH kev hloov pauv, xws li thaum itis nce siab hauv plab hnyuv, qhov no tuaj yeem cuam tshuam rau plab microbiota.

Cov zaub mov ntws kuj tau hloov kho, nrog cov khoom noj muaj txiaj ntsig tsawg dua hauv cov hnyuv hauv plab hauv qab-RYGB. Hauv qhov no, cov pa oxygen ua lub luag haujlwm tseem ceeb, vim tias qhov luv ntawm txoj hnyuv ntev hauv RYGB tuaj yeem ua rau muaj kev loj hlob ntawm facultativeanaerobes xws li Gammaproteobacteria thiab txo qis ntawm qee qhov aerobes21. Txawm li cas los xij, cov txheej txheem VG tsis qhia cov kev hloov pauv tseem ceeb, thiab cov kev hloov pauv hauv microbiotainduced los ntawm kev phais tshwm sim ntau dua thiab tsis hloov kho cov kab mob microbial tam sim no hauv plab. Thaum kawg, thaum sib piv ob txoj hauv kev, RYGB tau pom tias hloov kho lub plab microbiome tseem ceeb19.

Bypass phais nce plab hnyuv gluconeogenesis thiab txhim kho insulin tsis kam; qhov nce GLUT1 transporteron daim nyias nyias ntawm enterocytes txhim kho cov piam thaj nce ntxiv, thiab qhov no tshwm sim tsuas yog los txhawb cov ntaub so ntswg. Thehyperplasia ntawm plab hnyuv hlwb kuj piav qhia txog qhov nce ntxiv ntawm glucagon-derived peptides uas pab kev siv cov piam thaj. Thesodium-glucose co-transporter (SGLT1) kuj pab txo qis ntshav qabzib; Qhov no yog vim muaj sodium tam sim no nyob rau hauv cov kua tsib.Nrog rau qhov no, gastrectomy qeeb qabzib nqus nqus thiab tsis pom cov hnyuv hyperplasia8.Txawm li cas los xij, muaj kev tsis sib haum xeeb hauv cov txiaj ntsig ntawm cov kab mob no, vim qee qhov kev tshawb fawb nrog cov neeg mob rog pom kev hloov pauv ntawm cov kab mob tom qab. phais, hos lwm tus qhia qhov opposite nyhuv.

Cov kab mob ntawm ob peb lub hlis tom qab kev phais tau hloov zuj zus, thiab ntawm 3 lub hlis, nws tuaj yeem pom tias cov kab mob uas ua rau cov microbiome tsis zoo ib yam. Cov kev hloov pauv tsis tau txuas ntxiv mus rau lub sijhawm ntev, rov qab mus rau qhov pib ua ntej tom qab 12 lub hlis, tab sis kev txhim kho hauv cov metabolism tsis zoo. Yog li, tom qab 12 lub hlis tom qab kev phais, cov kab mob bacterialprofile zoo ib yam li cov preoperative one5,19. Lwm cov kev kawm tom qab phais tsis tau muaj qhov hloov pauv sai hauv microbiome tom qab phais, tab sis kev txhim kho hauv cov metabolism tau ua tiav tom qab 1 xyoos.

Cov kev sib txawv no qhia tau hais tias microbiomechange ib leeg tsis tuaj yeem txhawb nqa cov txiaj ntsig ua tiav nyob rau lub sijhawm ntev, vim tias cov kab mob hauv pawg ua haujlwm sib koom ua ke los txhim kho cov metabolism hauv cov metabolism21.Shao li al. ua kev tshawb fawb nrog cov nas uas ua tiav txoj kev phais bariatric ntawm VG hom thiab RYGB. Tom qab kev soj ntsuam apostprocedural rau 1, 3, 6, thiab 9 lub lis piam, lawv pom tias qhov ua tau zoo ntawm kev phais bariatric cuam tshuam nrog lawv cov teebmeem ntawm lub plab microbiota, vim tias muaj kev hloov pauv hauv cov ntsiab lus, cov ntsiab lus noob, thiab fermentation profiles ntawm microbes hauv plab, txhawb kev txo qis. zuag qhia tag nrho adiposity, kev txhim kho sai hauv cov piam thaj metabolism, thiab tshem tawm cov rog rog tom qab cov txheej txheem.

Lub phenotype ntawm circulating microorganisms thiab biomarkersoccurs disparately thiab thoob plaws hauv lub cev. Txhawm rau tshawb xyuas qhov muaj nyob ntawm biomarkers uas cuam tshuam nrog cov txiaj ntsig sib txawv hauv txhua txoj kev phais, nws tau pom tias cov kab mob bacterialgenus Veillonella yuav yog tus cwj pwm zoo tshaj plaws ntawm cov txheej txheem RYGB, thaum Blautia yuav yog biomarkerof VG phais. Kev ntsuam xyuas tom qab ua haujlwm microbiota profile, RYGB cov txheej txheem tau pom los hloov cov microbiome ntau dua.

Yog li, txoj kev hloov pauv ntawm lub teeb liab tau txais txiaj ntsig zoo li qhov degradation thiab metabolism ntawm xenobiotics.Lwm txoj hauv kev hloov pauv tom qab phais tau txo qis aminosugar thiab nucleotide qab zib metabolism, alanine, aspartate, andglutamate metabolism, thiab glycolysis / glyconeogenesis19,20.Muaj kev cuam tshuam ncaj qha ntawm Qee hom kab mob thiab cov txheej txheem phais. Nws tau pom tias hauv RYGB, ntxiv rau qhov poob phaus, kev hloov pauv hauv qhov profile ntawm microbiota tau ua tau. Firmicutes phyla tau cuam tshuam nrog qib zoo ntawm glycated hemoglobin thiab txhim kho AT hauv lub cev. Qhov tsis sib xws, cov txheej txheem VG tau pom qhov txuas rau Akkermansiamuciniphila hom, uas cuam tshuam rau kev txhim kho cov metabolism, txo qis adiposity, thiab mob. A. muciniphila tsim cov metabolites tau los ntawm nws cov fermentation uas ua haujlwm asubstrate rau lwm cov kab mob19.

Cov kev tshawb pom pov thawj los ntawm kev tshawb fawb los ntawm Autonomous University of Barcelona thiab Chicagoteaching tsev kho mob tau pom tias hloov cov microbiome altersmetabolism tag nrho, cov kab mob hloov pauv biomarkers, thiab kev sib raug zoo ntawm plab microbiome thiab txhim kho tag nrho lub cev metabolism. Txoj kev tshawb no tau saib ntawm 26 tus neeg mob, 8 ntawm lawv nrog DM2, 9 noj metformin, 11 kho rau ntshav siab, 10 rau dyslipidemia, thiab tsuas yog ib tus neeg muaj keeb kwm mob plawv. Qhov profile ntawm cov kab mob microorganisms tau txhim kho, tab sis qhov kev hloov pauv no tsis tuaj yeem ua rau lub sijhawm ntev. BAs thiabbutyrate muaj lawv cov kab mob sib xyaw ua ke tau hloov pauv ntau lub hlis dhau los tom qab kev phais20.Metabolites tau los ntawm cov kab mob metabolic xws li BAs, SCFAs, trimethylamine N-oxide (TMAO), betaine, andcholine tau hloov lawv cov dej num, ua rau cov neeg mob muaj txiaj ntsig; Piv txwv li, TMAO ntau ntau yog txuam nrog kev pheej hmoo siab ntawm cov kab mob plawv21.

Hais txog BCAA, muaj pov thawj tias kev ntxiv muaj txiaj ntsig zoo; txawm li cas los xij, cov qib kev rog, insulin tsis kam, thiab DM2 tau nce. BCAA-mediated insulin kuj tshwm sim vim nws inhibits phosphorylation ntawm insulin receptor (IRS-1). Cov neeg mob uas muaj cov tshuaj insulin tsis tsuas yog nce qib ntawm BCAA tab sis kuj muaj nyob rau hauv lawv cov microbiota zoo ntawm cov kab mob ntawm hom Prevotella copri thiab Bacteroidesvulgatus, uas yog hom muaj feem xyuam rau kev nthuav qhia cov noob uas ua rau biosynthesis ntawm BCAA3.BAs yog synthesized nyob rau hauv lub siab, khaws cia rau hauv lub gallbladder, thiab secreted rau hauv lub duodenum nyob rau hauv teb rau cov as-ham thiab lawv cov kev xav tau kev nqus. Lawv ua raws li surfactants thiab tseem ceeb hauv kev sib tawg thiab nqus cov tshuaj thiab txhawb kev tso tawm ntawm cov tshuaj hormone GLP-1, synthesized los ntawm L hlwb ntawm txoj hnyuv.

Lawv kuj yog ntuj ligands ntawm TGR5 receptor, qhia nyob rau hauv L hlwb, uas muaj feem xyuam rau kev txhim kho cov piam thaj, qhov ua rau poob phaus, thiab txo qhov mob 6,8. BAs tuaj yeem tswj cov kab mob ntawm lub plab microbiota. Yog li, lawv ua lub luag haujlwm tseem ceeb hauv kev tswj hwm plab hnyuv microbiota, insulin rhiab heev, tiv thaiv kab mob hauv lub cev, thiab sib npaug lipid thiab carbohydratemetabolism. Lub bioconversion yuam kev ntawm thawj BAs (PBA) mus rau theem nrab BAs (SBA) ua rau fecal dysbiosis nrog rau cov metabolic dysfunction thiab yog mechanistically txuam nrog gastrointestinal carcinogenesis, nrog rau mob qog nqaij hlav hauv plab thiab hepatocellular carcinoma17.Lub mechanism ntawm BA nyob rau hauv lub ntsej muag ntawm kev phais. Hauv lub cev qhov hnyav thiab cov metabolism hauv suav nrog txo cov kab mob hauv lub cev thiab cov kab mob siab, uas muaj, vim li ntawd, kev siv tshuaj insulin ntau dua yam tsis tau nce GLP-1 thiab insulin secretion6.

Kev sib raug zoo ntawm BAmetabolism thiab plab microbiota yog nyob rau hauv Farnesoid X receptor (FXR). Cov neeg mob nyob rau hauv lub plab bypass tau tsim ib "kev noj qab haus huv" plab microbiota, nrog txo Bacteroides thiab nce Roseburia. Cov kev hloov no tsis pom nyob rau hauv FXR knockout nas thiab qhia txog FXR-dependent signaling pathway. Lwm qhov kev tshawb pom yog tias cov microbiota metabolizes BAs, uas yog lub luag haujlwm rau kev tsim PBA thiab SBA uas qhib FXR, yog li txhawb kev tso tawm cov tshuaj hormones hauv plab xws li asfibroblast kev loj hlob zoo -19 (FGF19), uas nyob rau hauv lem stimulates BAin nws synthesis. , nce tswv zog noj. Yog li ntawd, nce qib ntawm FGF19 thiab BAs tau pom nyob rau hauv cov neeg laus uas muaj kev phais bypass phais tom qab 1 lub hlis. Tib yam tsis tshwm sim rau cov neeg rog rog uas tau txais tshuaj 17.

Cov neeg mob nrog NAFLD muaj cov qib BA hauv ntshav siab, zoo li cov neeg mob bariatric, tab sis PBA / ABS piv rau cov neeg mob bariatric feem ntau qis dua piv rau cov neeg mob NAFLD.Qhov kev tshawb pom no tsis cuam tshuam txog qhov hnyav tom qab phais.poob txij li qib BA txo qis tom qab poob phaus nrog caloricrestriction thiab nrog kev kho mob plab 21,22. Kev hloov pauv hauv plab hnyuv hauv cov txheej txheem RYGB ua rau cov zaub mov tsis zoo kom ncav cuag qhov nruab nrab ntawm cov hnyuv me nrog qhov siab dua ntawm BA. Ib qho txiaj ntsig zoo sib xws muaj nyob hauv cov txheej txheem SG. Kev hloov hauv plab hnyuv tau tshwm sim kom ilealreabsorption ntawm BA yog qhov ua tau zoo dua qub, ua kom pom tseeb qhov nce hauv cov ntshav tom qab phais bariatric11,26. Hauv lwm lo lus, txawm hais tias feem ntau ntawm cov kev sim kev tshawb fawb tau ua nyob rau hauv no topicare nrog cov tsiaj thiab kev soj ntsuam kev tshawb fawb muaj tsawg, nws paub tias bariatric phais plays lub luag hauj lwm tseem ceeb nyob rau hauv theetiopathogenesis ntawm NAFLD.

Yog li ntawd, qhov kev hloov pauv ntawm lub plab microbiota tom qab phais bariatric thiab kev cuam tshuam ntawm PBA / SBA piv hauv plasma induce metabolic kev txhim kho uas tsis tas yuav nyob ntawm qhov hnyav 2,24.Raws li tau piav qhia ua ntej, microbiota muaj kev cuam tshuam zoo rau kev tiv thaiv kab mob ntawm tib neeg lub cev. Kev rog rog yog ib yam kab mob ntawm cov kab mob qis qis uas tsim cov kab mob hauv AT, uas tuaj yeem ua rau mob nruab nrab thiab mob ntev. Lawv cuam tshuam rau kev tsim cov inflammatorycytokines thiab chemokines uas nrhiav cov kab mob inflammatory hauv AT6,8. Qhov kev nce hauv cov txheej txheem inflammatory tuaj yeem ua rau lub plab phab ntsa tsis muaj zog, ua rau ntau tus neeg rog rog muaj dysbiosis ntawm plab microbiota14. Macrophages yog cov kab mob tseem ceeb hauv AT thiab nthuav tawm cov cim sib xyaw hauv cov neeg rog. Lub voj voog tsis tu ncua thiab kev ua tsis zoo ntawm cov metabolism yog tshwm sim los ntawm kev ua ntawm lymphocytes, mastcells, thiab neutrophils14. Qee cov tshuaj chemokines xws li MCP1 kuj pab rau kev nrhiav cov hlwb pro-inflammatory23.

Kev nthuav qhia ntawm pro-inflammatory cytokines xws li IL-1 , IL-6, IL-8, MIP-1 , IFN- , thiab TNF- tau nce ntau inobese poj niam10,26. Muaj qhov txo qis hauv adipocytes, tom qab kev phais mob, nrog rau kev txo qis ntawm cov proinflammatory cytokines xws li CD4, CD{10}}, thiab monocytes, ua rau txo qis hauv lub cev hnyav thiab kev txhim kho metabolic. Hloov pauv hauv cov receptors. tam sim no ntawm monocytes, xws li TLR4 receptor, uas tuaj yeem paub cov kab mob LPS, thaj chaw cuam tshuam nrog kev hloov kho ntawm microbiota. Th1 lymphocyteshave kuj hloov lawv cov phenotype. Hauv kev rog rog, lawv muaj cov kab mob ua paug thiab Th1 / Th2 piv uas hloov pauv tom qab phais 8. Yog li ntawd, raws li kev txhim kho hauv cov ntshav qabzib cov cheeb tsam uas muaj ntau dua ntawm Th2, feem ntau, qhov profile ntawm cov qog nqaij hlav ua rau qis qis tom qab phais bariatric.

Cov piam thaj hauv cov ntshav tuaj yeem txhim kho nyob rau ob peb hnub tom qab gastricbypass, thiab kev txwv caloric tom qab phais ua rau poob phaus thiab tseem hloov pauv hauv cov tshuaj hormones hauv plab, xws li GLP-1, CCK, PYY, OXN, thiab thaum kawg glycine. Tus nqi ntawm qhov hnyav poob kuj cuam tshuam rau kev tshem tawm cov ntshav qab zib. Tsis tas li ntawd, kev phais bariatric nrog nws qhov yuag poob simproves insulin rhiab heev, tshwj xeeb tshaj yog thaum piv rau gastricbypass piv rau kev txwv kev noj haus 6,8. Ntxiv nrog rau kev tswj hwm kev noj zaub mov, cov tshuaj hormones hauv plab cuam tshuam rau insulin secretion thiab tiv thaiv.GLP-1 yog cov tshuaj hormones uas tau kawm tshaj plaws tom qab phais bariatric, thiab cov neeg mob DM2 tau txo qis cov tshuaj hormones no hauv lub sijhawm postprandial18,26.Qhov tso tawm ntawm GLP{{ 7}} nce tom qab phais bariatric, txhim kho cov tshuaj insulin.

Hauv kev tshuaj xyuas cov ntaub ntawv, Debédatet al. pov thawj tias tom qab cov neeg mob hypoglycemia tshwm sim los ntawm anincrease nyob rau hauv cov beta hlwb tom qab phais bariatric, lub pancreas ua ib tug adaptation tom qab phais, yog li regulating tej teeb meem 8. Qhov loj ntawm beta hlwb tau hloov pauv hauv cov txiav txiav ntawm cov neeg mob uas ua rau lub plab zom mov, thiab lawv raug kev txom nyem los ntawm cov tsos mob neuroglycopenic ntawm postprandialhypoglycemia. Txawm li cas los xij, cov kev tshawb pom yog heterogeneous; Lwm qhov kev tshawb fawb ntawm cov neeg mob rog tau pom tias muaj qhov nce hauv cov beta-cell loj hauv pancreatic ua ntej thiab tom qab ua tiav VG thiab gastric bypass ntawm tag nrho 26 tus neeg mob rog rog, qee tus nrog DM2 thiab lwm tus tsis muaj ntshav qab zib. Txawm hais tias kev txhim kho hauv qabzib homeostasis, txawm tias nrog kev phais, kev ua haujlwm ntawm beta-cell tsis zoo, thiab nws tsis pib ua rau cov neeg uas ib txwm nyias nyias, txawm tias qhov hnyav ntawm tus neeg mob bariatric2.GLP-2 kuj zoo li. los pab hauv kev txhim kho metabolic, thiab nws cov nyiaj tau nce ntau heev tom qab lub plab zom mov.

Cov tshuaj no muaj kev tiv thaiv kab mob hauv plab hnyuv thiab kab mob 8. Lwm cov tshuaj hormones hauv plab uas kev phais mob cuam tshuam nrog yog ghrelin, ib qho orexigenic peptide tsim los ntawm lub plab zom mov. Plasma qib ntawm ghrelin nce ua ntej noj mov thiab txo qis postprandial. Nrog rau kev noj zaub mov kom poob phaus, qib ghrelin nce ntxiv thiab qhov no yuav cuam tshuam rau kev rov qab los ntawm qhov hnyav poob tom qab noj mov, thaum tom qab lub plab zom mov, cov qib ntshav ntawm ghrelin qis dua 2. Ghrelinis txo qis los ntawm VG, uas kuj txo qhov hnyav nce thiab noj zaub mov thiab txhim kho cov lus teb rau GLP-1 cov tshuaj hormones. PYYhormone yog ib qho tshuaj hormones anorexigenic secreted los ntawm cov hlwb hauv cov hlab ntsha thiab cov hnyuv hauv cov lus teb rau cov khoom noj khoom haus stimulation; nws muaj anappetite-suppressing nyhuv nyob rau hauv cov neeg rog rog. Thaum kawg, foregutand anti-incretin txo qis pathophysiological nce hauv antiincretin signaling uas ib txwm pab tiv thaiv postprandialhypoglycemia los ntawm neutralizing incretin-mediated insulin.

Ntuj Herbal Tshuaj Rau Relieving cem quav-Cistanche

Cistanche yog ib tug genus ntawm parasitic nroj tsuag uas belongs rau tsev neeg Orobanchaceae. Cov nroj tsuag no paub txog lawv cov khoom siv tshuaj thiab tau siv hauv Cov Tshuaj Suav Tshuaj (TCM) rau ntau pua xyoo. Cov hom Cistanche feem ntau pom muaj nyob hauv thaj av qhuav thiab suab puam ntawm Tuam Tshoj, Mongolia, thiab lwm qhov chaw ntawm Central Asia. Cistanche nroj tsuag yog tus cwj pwm los ntawm lawv cov nqaij tawv, yellowish stems thiab muaj nuj nqis heev rau lawv cov txiaj ntsig kev noj qab haus huv. Hauv TCM, Cistanche ntseeg tau tias muaj cov khoom siv tonic thiab feem ntau yog siv los kho lub raum, txhim kho qhov tseem ceeb, thiab txhawb kev ua haujlwm ntawm kev sib deev. Nws kuj yog siv los daws cov teeb meem ntsig txog kev laus, qaug zog, thiab kev noj qab haus huv tag nrho. Thaum Cistanche muaj keeb kwm ntev ntawm kev siv tshuaj ib txwm siv, kev tshawb fawb tshawb fawb txog nws txoj kev ua tau zoo thiab kev nyab xeeb yog tsis tu ncua thiab txwv. Txawm li cas los xij, nws paub tias muaj ntau yam bioactive tebchaw xws li phenylethanoid glycosides, iridoids, lignans, thiab polysaccharides, uas tuaj yeem ua rau nws cov teebmeem tshuaj.

Wecistanche covcistanche hmoov, cistanche ntsiav tshuaj, cistanche capsules,thiab lwm yam khoom tsim los sivsuab puamcistancheraws li cov khoom siv raw, txhua yam muaj txiaj ntsig zoo rau kev tshem tawm cem quav. Cov txheej txheem tshwj xeeb yog raws li hauv qab no: Cistanche ntseeg tau tias muaj cov txiaj ntsig zoo rau kev tshem tawm cem quav raws li nws cov kev siv ib txwm siv thiab qee cov tshuaj uas nws muaj. Txawm hais tias kev tshawb fawb tshawb fawb tshwj xeeb ntawm Cistanche qhov cuam tshuam rau cem quav yog txwv, nws tau xav tias muaj ntau lub tswv yim uas yuav ua rau nws muaj peev xwm txo tau cem quav. Laxative nyhuv:Cistanchetau ntev tau siv nyob rau hauv tsoos suav tshuaj raws li ib tug tshuaj rau cem quav. Nws ntseeg tau tias muaj cov nyhuv laxative me me, uas tuaj yeem pab txhawb kev zom zaub mov thiab ua rau cem quav. Cov nyhuv no tuaj yeem raug ntaus nqi rau ntau lub tebchaw nyob hauv Cistanche, xws li phenylethanoid glycosides thiab polysaccharides. Moistening cov hnyuv: Raws li kev siv ib txwm siv, Cistanche suav hais tias muaj cov khoom siv moisturizing, tshwj xeeb yog tsom rau cov hnyuv. Txhawb nqa dej thiab lubrication ntawm cov hnyuv yuav pab tau cov cuab yeej soften thiab yooj yim dua, yog li no relieving cem quav. Anti-inflammatory Effect: cem quav tej zaum yuav txuam nrog o nyob rau hauv lub plab zom mov. Cistanche muaj qee qhov sib txuas, suav nrog phenylethanoid glycosides thiab lignans, uas ntseeg tau tias muaj cov tshuaj tiv thaiv kab mob. Los ntawm kev txo cov kab mob hauv cov hnyuv, nws tuaj yeem pab txhim kho kev zom zaub mov tsis tu ncua thiab txo qhov cem quav.