| 摘要: | 長期熱量攝取過多導致肥胖症發生，造成體內慢性低度發炎及代謝問題如胰島素阻抗 (IR)、葡萄糖耐受性下降、血脂異常等，與多種慢性合併症相關。胃袖狀切除手術 (SG) 是肥胖病患有效治療方式，但肥胖亦是手術患者預後不佳之危險因子，精胺酸 (Arg) 具有免疫調節、促進傷口癒合、改善體內發炎及代謝之益處，常作為患者術後腸內免疫營養配方，然而目前台灣尚無給予手術後患者靜脈補充Arg之應用，故本研究以肥胖小鼠模式探討靜脈補充Arg，探討其對於肥胖小鼠在SG術後體內發炎及代謝之影響。本研究使用55隻C57BL/6雄性小鼠，依據不同的飲食介入隨機將小鼠分為: 正常飲食組 (ND) 及高脂飲食組 (HFD)。ND小鼠作為本實驗之控制組 (NC)，不進行手術與靜脈注射；HFD組小鼠經16-18週誘發肥胖後進行手術，依據是否進行胃切除以及尾靜脈注射Saline (0.9 %) 或Arg (300 mg/kg BW) 再次分為: 假手術組 (SH)、Sleeve Gastrectomy-Saline group (SS) 及Sleeve Gastrectomy-Arginine group (SA)，於手術後1小時及1天經由尾靜脈注射100 μL之Saline或Arg，小鼠於術後1天及3天犧牲，收集血漿、腹腔沖洗液、肝臟、副睪脂肪組織進行後續分析。結果顯示補充Arg可以降低腹腔沖洗液IL-1β濃度，以及副睪脂肪TNF-α、IL-1β、IL-6 mRNA表現，調節脂肪激素分泌包含血漿Leptin降低和Adiponectin增加，減少副睪脂肪M1巨噬細胞浸潤指標mRNA表現，顯示Arg可以減輕術後腹腔發炎反應。在代謝方面可改善術後血漿TG濃度的急遽增加，並提升HDL-C濃度，維持代謝穩定。
Long-term excessive caloric intake leads to obesity, chronic low-grade inflammation and metabolic abnormalities, such as insulin resistance (IR), glucose intolerance, lipidemia, etc., associated with variety of chronic complications. Sleeve gastrectomy (SG) is an effective treatment for obese patients. However previous studies have shown that obesity is a risk factor for poor surgical outcome. Arginine (Arg) has benefits on immune, wound healing, anti-inflammation and metabolism, and is often used as a formulation for post-surgical enteral nutrition in patients. Therefore, this study was conducted to investigate the effects of intravenous Arg supplementation on inflammation and metabolism in obese mice after SG surgery. In this study, 55 male C57BL/6 mice were randomly divided into normal diet (ND) and high fat diet (HFD) groups according to different dietary interventions. The mice in the HFD group were divided into sham group (SH), Sleeve Gastrectomy-Saline group (SS) and Sleeve Gastrectomy-Arginine group (SA), depending on whether they underwent gastrectomy and intravenous tail injection of Saline (0.9%) or Arg (300 mg/kg BW). Mice were sacrificed at 1 and 3 days after operation. Plasma, peritoneal lavage fluid (PLF), liver, and epididymal fat were collected for follow-up analysis. The results showed that Arg supplementation could reduce concentration of IL-1β in PLF, and mRNA expression of TNF-α, IL-1β, and IL-6 mRNA in epididymal fat. In addition, regulating adipokines secretion, including decreased leptin and increased adiponectin concentration in plasma. Moreover, reducing M1 macrophage mRNA expression in epididymal fat. Indicating that Arg could lower the postoperative inflammatory response in the peritoneal cavity. In the part of nutrient metabolism showed that concentration of TG was lower, and HDL-C was higher after Arg supplementation, indicating that Arg seems to maintain stable metabolic state compared to group without Arg. |
