Jensen D E, Nguo K, Baxter K A, Cardinal J W, King N A, Ware R S, Truby H, Batch J A
Children's Health Queensland Hospital and Health Service, Department of Endocrinology and Diabetes, Royal Children's Hospital, Herston, Queensland, Australia.
Queensland Children's Medical Research Institute, University of Queensland, Herston, Queensland, Australia.
Pediatr Obes. 2015 Oct;10(5):380-7. doi: 10.1111/ijpo.275. Epub 2015 Jan 5.
Gut hormones change with weight loss in adults but are not well studied in obese youth.
The primary aim was to evaluate how gut hormones and subjective appetite measure change with dietary weight loss in obese adolescents.
Participants were a subset of those taking part in the 'Eat Smart Study'. They were aged 10-17 years with body mass index (BMI) > 90th centile and were randomized to one of three groups: wait-listed control, structured reduced carbohydrate or structured low-fat dietary intervention for 12 weeks. Outcomes were fasting glucose, insulin, leptin, adiponectin, total amylin, acylated ghrelin, active glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide (GIP), pancreatic polypeptide (PP) and total peptide tyrosine-tyrosine. Pre- and postprandial subjective sensations of appetite were assessed using visual analogue scales.
Of 87 'Eat Smart' participants, 74 participated in this sub-study. The mean (standard deviation) BMI z-score was 2.1 (0.4) in the intervention groups at week 12 compared with 2.2 (0.4) in the control group. Fasting insulin (P = 0.05) and leptin (P = 0.03) levels decreased, while adiponectin levels increased (P = 0.05) in the intervention groups compared with control. The intervention groups were not significantly different from each other. A decrease in BMI z-score at week 12 was associated with decreased fasting insulin (P < 0.001), homeostatic model of assessment-insulin resistance (P < 0.001), leptin (P < 0.001), total amylin (P = 0.03), GIP (P = 0.01), PP (P = 0.02) and increased adiponectin (P < 0.001). There was no significant difference in appetite sensations.
Modest weight loss in obese adolescents leads to changes in some adipokines and gut hormones that may favour weight regain.
肠道激素在成人体重减轻时会发生变化，但在肥胖青少年中尚未得到充分研究。
主要目的是评估肥胖青少年在饮食减肥过程中肠道激素和主观食欲指标如何变化。
参与者是参加“明智饮食研究”的一部分人群。他们年龄在10 - 17岁，体重指数（BMI）>第90百分位数，并被随机分为三组之一：候补对照组、结构化低碳水化合物饮食组或结构化低脂饮食干预组，为期12周。观察指标包括空腹血糖、胰岛素、瘦素、脂联素、总胰淀素、酰化胃饥饿素、活性胰高血糖素样肽 - 1、葡萄糖依赖性促胰岛素多肽（GIP）、胰多肽（PP）和总肽酪氨酸酪氨酸。使用视觉模拟量表评估餐前和餐后的主观食欲感受。
在87名“明智饮食”参与者中，74人参与了这项子研究。在第12周时，干预组的平均（标准差）BMI z评分是2.1（0.4），而对照组为2.2（0.4）。与对照组相比，干预组的空腹胰岛素（P = 0.05）和瘦素（P = 0.03）水平降低，而脂联素水平升高（P = 0.05）。各干预组之间无显著差异。第12周时BMI z评分的降低与空腹胰岛素（P < 0.001）、胰岛素抵抗稳态模型评估（P < 0.001）、瘦素（P < 0.001）、总胰淀素（P = 0.03）、GIP（P = 0.01）、PP（P = 0.02）降低以及脂联素升高（P < 0.001）相关。食欲感受方面无显著差异。
肥胖青少年适度体重减轻会导致一些脂肪因子和肠道激素发生变化，这可能有利于体重反弹。
