Serra-Prat Mateu, Palomera Elisabet, Clave Pere, Puig-Domingo Manel
Unidad de Investigación, Consorci Sanitari del Maresme and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.
Am J Clin Nutr. 2009 May;89(5):1410-7. doi: 10.3945/ajcn.2008.27076. Epub 2009 Apr 1.
Ghrelin and cholecystokinin (CCK) are among the peripheral signals that regulate hunger and satiety.
The objective was to assess whether ghrelin and CCK responses to a standard nutritional load are related to age and frailty.
Ghrelin, CCK, insulin, glucose, and 4-h visual analog hunger scale curves after a standard nutritional load test (380 kcal) were described and compared between 3 groups: old (>75 y) and frail persons (group A), old (>75 y) but nonfrail persons (group B), and young (25-65 y) adults (group C).
Frail persons showed no postprandial ghrelin suppression, and old subjects, frail and nonfrail, showed no significant postprandial ghrelin recovery compared with young adults. Frailty was also associated with lower fasting ghrelin concentrations. No differences in fasting CCK were observed between young and old persons; however, postprandial CCK concentrations were enhanced in young persons, whereas no frailty effect on the CCK curve was observed in the old subjects. No correlations between mean ghrelin and hunger values over time were found, but strong negative correlations were shown between CCK and hunger (group A: r(s) = -0.88, P = 0.009; group B: r(s) = -0.86, P = 0.014; group C: r(s) = -0.71, P = 0.071) and insulin and hunger (group A: r(s) = -0.901, P = 0.006; group B: r(s) = -0.964, P < 0.001; group C: r(s) = -0.929, P = 0.003).
Advanced age determines a poorer ghrelin postprandial recuperation phase, a reduced CCK postprandial response, and an exaggerated postprandial insulin release. A loss of ghrelin prandial rhythm is present in old frail persons. The impaired response of these hunger regulatory hormones with age might contribute to the mechanisms of anorexia associated with aging.
胃饥饿素和胆囊收缩素（CCK）是调节饥饿和饱腹感的外周信号。
评估胃饥饿素和CCK对标准营养负荷的反应是否与年龄和虚弱相关。
描述并比较了3组人群在标准营养负荷试验（380千卡）后的胃饥饿素、CCK、胰岛素、葡萄糖和4小时视觉模拟饥饿量表曲线：老年（>75岁）且虚弱的人群（A组）、老年（>75岁）但非虚弱的人群（B组）以及年轻（25 - 65岁）成年人（C组）。
虚弱人群餐后胃饥饿素无抑制，与年轻成年人相比，老年人群（包括虚弱和非虚弱）餐后胃饥饿素无显著恢复。虚弱还与空腹胃饥饿素浓度较低有关。年轻人和老年人空腹CCK无差异；然而，年轻人餐后CCK浓度升高，而老年人群中未观察到虚弱对CCK曲线有影响。未发现胃饥饿素均值与饥饿值随时间的相关性，但CCK与饥饿（A组：r(s)= -0.88，P = 0.009；B组：r(s)= -0.86，P = 0.014；C组：r(s)= -0.71，P = 0.071）以及胰岛素与饥饿（A组：r(s)= -0.901，P = 0.006；B组：r(s)= -0.964，P < 0.001；C组：r(s)= -0.929，P = 0.003）之间存在强负相关。
高龄导致胃饥饿素餐后恢复阶段较差、餐后CCK反应降低以及餐后胰岛素释放过度。老年虚弱人群存在胃饥饿素餐时节律丧失。这些饥饿调节激素随年龄的反应受损可能有助于解释与衰老相关的厌食机制。
