Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, NY (RS, MJD, JS, EZ, BTW); the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY (RS, MJD, JS, EZ, BTW); the Department of Medical and Clinical Psychology, Uniformed Services University of Health Sciences, Bethesda, MD (MT-K); the Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (MT-K and JAY); the Department of Medicine, Columbia University, New York, NY (JK); and the Center for Adolescent Bariatric Surgery, Department of Surgery, Division of Pediatric Surgery, Columbia University Medical Center, New York, NY (JLZ).
Am J Clin Nutr. 2013 Nov;98(5):1151-61. doi: 10.3945/ajcn.113.061762. Epub 2013 Aug 28.
Relatively little is known about changes in eating behavior or hormonal responses to food after bariatric surgery in adolescents.
This study compared eating behavior and hormones among adolescents in a bariatric surgery program with those in nonoverweight control adolescents and evaluated changes before and after laparoscopic adjustable gastric banding (LAGB).
Fasting leptin, peptide YY (PYY), and ghrelin concentrations were obtained, and postprandial ghrelin and PYY area under the curve (AUC) were assessed after a single-item breakfast. Intake from an ad libitum lunchtime multi-item meal was measured.
Compared with controls (n = 9), all presurgical candidates (n = 20) had significantly greater fasting leptin, lower fasting ghrelin, and lower AUC ghrelin but similar PYY and AUC PYY. Preoperative candidates did not differ from controls in total energy consumed during the test meal. Postoperatively, among the 11 participants with data both before and after surgery, BMI (in kg/m(2)) decreased by 3.5 (P < 0.001), significantly less energy was consumed in the test meal, and a smaller number of foods were selected. AUC ghrelin and PYY did not significantly change before or after LAGB.
Few significant short-term changes were observed in appetitive hormones after LAGB. It is unclear whether objective measures of eating behavior will prove useful in evaluating the impact of bariatric surgery on outcomes. This trial was registered at clinicaltrials.gov as CT00764127.
人们对于青少年接受减重手术后饮食行为或对食物的激素反应变化知之甚少。
本研究比较了减重手术计划中的青少年与非超重对照组青少年的饮食行为和激素，并评估了腹腔镜可调胃束带术（LAGB）前后的变化。
空腹时测定瘦素、肽 YY（PYY）和胃饥饿素浓度，单次早餐后评估餐后胃饥饿素和 PYY 曲线下面积（AUC）。测量自由选择午餐多项目饮食的摄入量。
与对照组（n = 9）相比，所有术前候选者（n = 20）的空腹瘦素显著增加，空腹胃饥饿素显著降低，胃饥饿素 AUC 降低，但 PYY 和 PYY AUC 相似。术前候选者与对照组在测试餐中消耗的总能量没有差异。在 11 名接受术前和术后数据的参与者中，BMI（kg/m2）下降了 3.5（P < 0.001），测试餐中消耗的能量显著减少，选择的食物数量减少。LAGB 前后，AUC 胃饥饿素和 PYY 没有显著变化。
LAGB 后食欲激素仅有少数短期变化。尚不清楚客观的饮食行为测量方法是否有助于评估减重手术对结果的影响。本试验在 clinicaltrials.gov 注册，注册号为 CT00764127。
