Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
Obes Surg. 2013 May;23(5):622-33. doi: 10.1007/s11695-012-0834-6.
Satiety is centrally and peripherally mediated by gastrointestinal peptides and the vagal nerve. We aimed to investigate whether intragastric balloon treatment affects satiety through effects on fasting and meal-stimulated cholecystokinin (CCK) and pancreatic polypeptide (PP) secretion.
Patients referred for obesity treatment were randomised to 13 weeks of sham treatment followed by 13 weeks of balloon treatment (group 1; sham/balloon) or to twice a 13-week period of balloon treatment (group 2; balloon/balloon). Blood samples were taken for fasting and meal-stimulated CCK and PP levels at the start (T0) and after 13 (T1) and 26 (T2) weeks. Patients filled out visual analogue scales (VAS) to assess satiety.
Forty-two patients (35 females, body weight 125.1 kg, BMI 43.3 kg/m(2)) participated. In group 1, basal CCK levels decreased but meal-stimulated response remained unchanged after 13 weeks of sham treatment. In group 2, basal and meal-stimulated CCK levels decreased after 13 weeks of balloon treatment. At the end of the second 13-week period, when group 1 had their first balloon treatment, they duplicated the initial 13-week results of group 2, whereas group 2 continued their balloon treatment and reduced meal-stimulated CCK release. Both groups showed reduced meal-stimulated PP secretions at T1 and T2 compared to T0. Changes in diet composition and VAS scores were similar. Improvements in glucose homeostasis partly explained the PP results.
The reduced CCK and PP secretion after balloon positioning was unexpected and may reflect delayed gastric emptying induced by the balloon. Improved glucose metabolism partly explained the reduced PP secretion. Satiety and weight loss were not adversely influenced by these hormonal changes.
饱腹感是由胃肠道肽和迷走神经中枢和外周介导的。我们旨在研究胃内球囊治疗是否通过影响空腹和餐刺激胆囊收缩素（CCK）和胰多肽（PP）分泌来影响饱腹感。
将接受肥胖治疗的患者随机分为 sham 治疗 13 周，然后进行 13 周的球囊治疗（第 1 组；sham/balloon）或两次进行 13 周的球囊治疗（第 2 组；balloon/balloon）。在开始时（T0）和 13 周（T1）和 26 周（T2）时，采集血样以测量空腹和餐刺激 CCK 和 PP 水平。患者填写视觉模拟量表（VAS）以评估饱腹感。
42 名患者（35 名女性，体重 125.1kg，BMI 43.3kg/m2）参与了研究。在第 1 组中，在 sham 治疗 13 周后，基础 CCK 水平下降，但餐刺激反应保持不变。在第 2 组中，在球囊治疗 13 周后，基础和餐刺激 CCK 水平下降。在第二个 13 周治疗结束时，当第 1 组接受第一次球囊治疗时，他们复制了第 2 组最初的 13 周结果，而第 2 组继续进行球囊治疗并减少了餐刺激 CCK 释放。与 T0 相比，两组在 T1 和 T2 时均显示出餐后 PP 分泌减少。饮食组成和 VAS 评分的变化相似。葡萄糖代谢的改善部分解释了 PP 的结果。
球囊定位后 CCK 和 PP 分泌减少出乎意料，可能反映了球囊引起的胃排空延迟。改善的葡萄糖代谢部分解释了 PP 分泌减少。饱腹感和体重减轻不受这些激素变化的不利影响。
