Belinova Lenka, Kahleova Hana, Malinska Hana, Topolcan Ondrej, Windrichova Jindra, Oliyarnyk Olena, Kazdova Ludmila, Hill Martin, Pelikanova Terezie
Department of Diabetology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
First Faculty of Medicine, Charles University, Prague, Czech Republic.
PLoS One. 2017 Apr 3;12(4):e0174820. doi: 10.1371/journal.pone.0174820. eCollection 2017.
Appetite and gastrointestinal hormones (GIHs) participate in energy homeostasis, feeding behavior and regulation of body weight. We demonstrated previously the superior effect of a hypocaloric diet regimen with lower meal frequency (B2) on body weight, hepatic fat content, insulin sensitivity and feelings of hunger compared to the same diet divided into six smaller meals a day (A6). Studies with isoenergetic diet regimens indicate that lower meal frequency should also have an effect on fasting and postprandial responses of GIHs. The aim of this secondary analysis was to explore the effect of two hypocaloric diet regimens on fasting levels of appetite and GIHs and on their postprandial responses after a standard meal. It was hypothesized that lower meal frequency in a reduced-energy regimen leading to greater body weight reduction and reduced hunger would be associated with decreased plasma concentrations of GIHs: gastric inhibitory peptide (GIP), glucagon-like peptide-1(GLP-1), peptide YY(PYY), pancreatic polypeptide (PP) and leptin and increased plasma concentration of ghrelin. The postprandial response of satiety hormones (GLP-1, PYY and PP) and postprandial suppression of ghrelin will be improved.
In a randomized crossover study, 54 patients suffering from type 2 diabetes (T2D) underwent both regimens. The concentrations of GLP-1, GIP, PP, PYY, amylin, leptin and ghrelin were determined using multiplex immunoanalyses.
Fasting leptin and GIP decreased in response to both regimens with no difference between the treatments (p = 0.37 and p = 0.83, respectively). Fasting ghrelin decreased in A6 and increased in B2 (with difference between regimens p = 0.023). Fasting PP increased in B2with no significant difference between regimens (p = 0.17). Neither GLP-1 nor PYY did change in either regimen. The decrease in body weight correlated negatively with changes in fasting ghrelin (r = -0.4, p<0.043) and the postprandial reduction of ghrelin correlated positively with its fasting level (r = 0.9, p<0.001). The postprandial responses of GIHs and appetite hormones were similar after both diet regimens.
Both hypocaloric diet regimens reduced fasting leptin and GIP and postprandial response of GIP comparably. The postprandial responses of GIHs and appetite hormones were similar after both diet regimens. Eating only breakfast and lunch increased fasting plasma ghrelin more than the same caloric restriction split into six meals. The changes in fasting ghrelin correlated negatively with the decrease in body weight. These results suggest that for type 2 diabetic patients on a hypocaloric diet, eating larger breakfast and lunch may be more efficient than six smaller meals during the day.
食欲和胃肠激素（GIHs）参与能量平衡、进食行为及体重调节。我们之前证明，与一天分六小餐（A6）的相同热量饮食方案相比，较低进餐频率的低热量饮食方案（B2）在体重、肝脏脂肪含量、胰岛素敏感性及饥饿感方面具有更显著的效果。等能量饮食方案的研究表明，较低进餐频率也应对GIHs的空腹及餐后反应产生影响。这项二次分析的目的是探究两种低热量饮食方案对食欲和GIHs空腹水平及其在标准餐后的餐后反应的影响。研究假设是，在低能量饮食方案中较低的进餐频率导致更大程度的体重减轻和饥饿感降低，这将与GIHs的血浆浓度降低相关：胃抑制肽（GIP）、胰高血糖素样肽-1（GLP-1）、肽YY（PYY）、胰多肽（PP）和瘦素，以及胃饥饿素血浆浓度升高。饱腹感激素（GLP-1、PYY和PP）的餐后反应及胃饥饿素的餐后抑制将得到改善。
在一项随机交叉研究中，54例2型糖尿病（T2D）患者接受了两种饮食方案。使用多重免疫分析测定GLP-1、GIP、PP、PYY、胰淀素、瘦素和胃饥饿素的浓度。
两种饮食方案均使空腹瘦素和GIP降低，各治疗组间无差异（分别为p = 0.37和p = 0.83）。A6组空腹胃饥饿素降低，B2组升高（两组间差异p = 0.023）。B2组空腹PP升高，两组间无显著差异（p = 0.17）。两种饮食方案中GLP-1和PYY均未发生变化。体重减轻与空腹胃饥饿素的变化呈负相关（r = -0.4，p<0.043），胃饥饿素的餐后降低与其空腹水平呈正相关（r = 0.9，p<0.001）。两种饮食方案后GIHs和食欲激素的餐后反应相似。
两种低热量饮食方案均可同等程度地降低空腹瘦素和GIP以及GIP的餐后反应。两种饮食方案后GIHs和食欲激素的餐后反应相似。仅吃早餐和午餐比分成六餐的相同热量限制使空腹血浆胃饥饿素升高更多。空腹胃饥饿素的变化与体重减轻呈负相关。这些结果表明，对于采用低热量饮食的2型糖尿病患者而言，吃较大的早餐和午餐可能比一天吃六小餐更有效。
