Zhao Xue, Han Qing, Gang Xiaokun, Lv You, Liu Yujia, Sun Chenglin, Wang Guixia
Department of Endocrinology and Metabolism, the First Hospital of Jilin University, Changchun, China.
Hospital of Orthopedics, the Second Hospital of Jilin University, Changchun, China.
Horm Metab Res. 2017 Nov;49(11):816-825. doi: 10.1055/s-0043-115646. Epub 2017 Sep 21.
Gut hormones are known to play an important role in long-term weight loss maintenance after bariatric surgery. However, the interplay between gut hormones and diet-induced weight changes remains unclear. Our aims were to evaluate the alterations of gut hormones in diet-induced weight loss, weight maintenance, and weight regain periods. Available studies were searched on MEDLINE, EMASE, ClinicalTrials.gov, the Cochrane Library, and Web of science from inception to October 2016. After selection, 16 studies with 656 participants were included. Based on current evidence, we found significant alterations of gut hormones induced by different diets. In weight-loss diets, decreased fasting total PYY, GLP-1, CCK, GIP, PP, and amylin along with increased ghrelin levels were observed in most studies. After weight loss, the persistent decreases of fasting total PYY and GLP-1 levels as well as increased appetite were reported, suggesting the profound impact of altered gut hormones on later weight regain after dietary intervention. The differences between diet-induced changes in gut hormones and other treatments such as bariatric surgery and exercise are also discussed in this review. Although significant alterations of gut hormones were found during weight changes, huge heterogeneity exists in methods and populations. More large-scale studies with elaborate design addressing the gut hormone alterations in dietary weight regulation are required in the future.
已知肠道激素在减肥手术后长期维持体重减轻方面发挥着重要作用。然而，肠道激素与饮食引起的体重变化之间的相互作用仍不清楚。我们的目的是评估在饮食引起的体重减轻、体重维持和体重反弹期间肠道激素的变化。从创刊至2016年10月，在MEDLINE、EMASE、ClinicalTrials.gov、Cochrane图书馆和科学网中检索了现有研究。经过筛选，纳入了16项研究，共656名参与者。基于目前的证据，我们发现不同饮食会引起肠道激素的显著变化。在大多数研究中，在减肥饮食中，观察到空腹总肽YY、胰高血糖素样肽-1、胆囊收缩素、胃抑肽、胰多肽和胰岛淀粉样多肽水平降低，同时胃饥饿素水平升高。在体重减轻后，有报道称空腹总肽YY和胰高血糖素样肽-1水平持续下降以及食欲增加，这表明肠道激素改变对饮食干预后后期体重反弹有深远影响。本综述还讨论了饮食引起的肠道激素变化与其他治疗方法（如减肥手术和运动）之间的差异。虽然在体重变化期间发现了肠道激素的显著变化，但在方法和人群方面存在巨大的异质性。未来需要更多精心设计的大规模研究来探讨饮食体重调节中肠道激素的变化。
