Nutrition Postgraduate Program, Federal University of São Paulo/Paulista Medicine School, São Paulo, Brazil.
J Adolesc Health. 2011 Sep;49(3):300-5. doi: 10.1016/j.jadohealth.2010.12.016. Epub 2011 Apr 22.
The aim of this study was to verify the effects of a multidisciplinary therapy (24 weeks) on neurohormonal control of food intake, specifically in orexigenic (total ghrelin, agouti-related protein [AgRP], neuropeptide Y [NPY], and melanin-concentrating hormone) and anorexigenic factors (leptin, insulin, and alpha-melanocyte stimulating hormone [α-MSH]), in obese adolescents.
A total of 88 adolescents (38 boys and 50 girls), including 62 obese and 26 normal-weight, aged 15-19 years were recruited. Obese adolescents were submitted to a 24-week multidisciplinary therapy. AgRP, NPY, melanin-concentrating hormone, leptin, insulin, glucose, α-MSH, total ghrelin, and food intake were measured at three stages (at baseline, after 12 weeks, and after 24 weeks).
At baseline, obese adolescents showed hyperleptinemia (circulating leptin levels, which were, in boys and girls, 40 and 35 times higher than in normal-weight subjects, respectively). After 24 weeks, these values decreased in all obese patients. Our results showed no differences in ghrelin levels between obese and normal-weight adolescents, in both genders. However, obese boys reduced their plasma ghrelin concentration after 24 weeks of therapy (p < .05). The multidisciplinary therapy decreased NPY and AgRP values and increased α-MSH; simultaneously with these changes there was a decrease in total food intake after 24 weeks of therapy.
We can conclude that the multidisciplinary therapy was efficient to modulate neurohormonal control of food intake in obese adolescents.
本研究旨在验证多学科治疗(24 周)对摄食神经激素控制的影响,特别是在食欲肽(总 ghrelin、刺鼠相关蛋白[AgRP]、神经肽 Y[NPY]和黑色素浓缩激素)和厌食肽(瘦素、胰岛素和α-黑素细胞刺激素[α-MSH])方面,在肥胖青少年中。
共招募了 88 名青少年(38 名男孩和 50 名女孩),包括 62 名肥胖者和 26 名正常体重者,年龄为 15-19 岁。肥胖青少年接受了 24 周的多学科治疗。在三个阶段(基线时、12 周后和 24 周后)测量 AgRP、NPY、黑色素浓缩激素、瘦素、胰岛素、葡萄糖、α-MSH、总 ghrelin 和食物摄入量。
基线时,肥胖青少年表现出高瘦素血症(循环瘦素水平,男孩和女孩分别比正常体重组高 40 和 35 倍)。24 周后,所有肥胖患者的这些值均下降。我们的研究结果显示,在男性和女性肥胖青少年和正常体重青少年中,ghrelin 水平没有差异。然而,肥胖男孩在 24 周的治疗后降低了他们的血浆 ghrelin 浓度(p<.05)。多学科治疗降低了 NPY 和 AgRP 值并增加了 α-MSH;随着这些变化,治疗 24 周后总食物摄入量减少。
我们可以得出结论,多学科治疗对肥胖青少年的摄食神经激素控制具有调节作用。