Nemours Children's Clinic, Jacksonville, Florida, USA.
Obesity (Silver Spring). 2010 Sep;18(9):1747-53. doi: 10.1038/oby.2009.498. Epub 2010 Jan 21.
The aims of this study are to examine in children: (i) obesity-related alterations in satiety factors such as leptin, ghrelin, and obestatin; (ii) the link between satiety factors and cardiometabolic risk factors; and (iii) the impact of a physical activity-based lifestyle intervention on the levels of these satiety factors in the obese. We studied a total of 21 adolescents (BMI percentile, 99.0 +/- 0.6 for 15 obese and 56.2 +/- 1.1 for 6 lean). The obese subjects underwent a 3-month randomized controlled physical activity-based lifestyle intervention. Leptin, soluble leptin receptor (sOB-R), ghrelin, and obestatin levels were determined as the primary outcome measures. Other markers of cardiometabolic disease such as inflammation and insulin resistance were also determined. Body composition was measured by dual-energy X-ray absorptiometry. The concentrations of ghrelin, obestatin, and sOB-R were significantly lower in the obese children compared to the lean controls, whereas that of leptin was higher (all P < 0.05). Although intervention led to a net increase in obestatin (P < 0.01) and no change in ghrelin levels, the balance between ghrelin and obestatin (ratio of ghrelin to obestatin, G/O) decreased (P < 0.02). Intervention reduced leptin and increased sOB-R (P < 0.01 for both). Significant associations between satiety factors and other cardiometabolic risk factors were also observed. Taken together, alterations in the levels of satiety factors are evident early in the clinical course of obesity, but physical activity-based lifestyle intervention either prevented their continued increase or normalized their levels. These beneficial effects appear to aid in the maintenance of body weight and reduction in cardiovascular risk.
（i）饱腹感相关因子（如瘦素、ghrelin 和 obestatin）发生肥胖相关改变；（ii）饱腹感因子与心血管代谢危险因素之间的关联；（iii）基于身体活动的生活方式干预对肥胖者这些饱腹感因子水平的影响。我们共研究了 21 名青少年（BMI 百分位数，肥胖组为 99.0 +/- 0.6，对照组为 56.2 +/- 1.1）。肥胖组患者接受了为期 3 个月的随机对照基于身体活动的生活方式干预。以瘦素、可溶性瘦素受体（sOB-R）、ghrelin 和 obestatin 水平作为主要的观察指标。还测定了其他心血管代谢疾病标志物，如炎症和胰岛素抵抗。通过双能 X 射线吸收法测定身体成分。与对照组相比，肥胖组儿童的 ghrelin、obestatin 和 sOB-R 浓度显著降低，而瘦素浓度更高（均 P < 0.05）。尽管干预导致 obestatin 浓度显著升高（P < 0.01），ghrelin 水平无变化，但 ghrelin 和 obestatin 之间的平衡（ghrelin 与 obestatin 的比值，G/O）降低（P < 0.02）。干预还降低了瘦素并增加了 sOB-R（两者均 P < 0.01）。饱腹感因子与其他心血管代谢危险因素之间也存在显著关联。综上所述，在肥胖症的临床病程早期，饱腹感因子的水平发生改变，但基于身体活动的生活方式干预可防止其持续增加或使其水平恢复正常。这些有益影响似乎有助于维持体重和降低心血管风险。
