Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway.
Centre for Obesity Research (ObeCe), Clinic of Surgery, St. Olav University Hospital , Trondheim , Norway.
Am J Physiol Endocrinol Metab. 2018 Jul 1;315(1):E91-E98. doi: 10.1152/ajpendo.00322.2017. Epub 2018 Jan 23.
The impact of lifestyle-induced weight loss (WL) on appetite in patients with obesity remains controversial. This study aimed to assess the short- and long-term impact of WL achieved by diet and exercise on appetite in patients with obesity. Thirty-five (22 females) adults with severe obesity (body mass index: 42.5 ± 5.0 kg/m) underwent a 2-yr WL program focusing on diet and exercise. Body weight (BW), cardiovascular fitness (V̇o), appetite feelings, and plasma concentrations of insulin, active ghrelin (AG), glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and cholecystokinin (CCK), in the fasting and postprandial states, were measured at baseline (B), week 4 (W4), and 1 and 2 yr (and average values for all fasting and postprandial time points computed). BW was significantly reduced and V̇o (ml·kg·min) increased at all time points compared with B (3.5, 8.1, and 8.4% WL and 7, 11, and 8% increase at W4 and 1 and 2 yr, respectively). Basal hunger and average hunger and desire to eat were significantly increased at 1 and 2 yr. Basal fullness was significantly increased at W4, and average ratings were reduced at 1 yr. Average AG and PYY were significantly increased, and insulin was reduced, at all time points compared with B. Average GLP-1 was reduced at W4, and CCK was increased at 2 yr. After lifestyle-induced WL, patients with severe obesity will, therefore, have to deal with increased hunger in the long term. In conclusion, sustained WL at 2 yr achieved with diet and exercise is associated with increased hunger feelings and ghrelin concentration but also increased postprandial concentrations of satiety hormones.
生活方式引起的体重减轻（WL）对肥胖患者的食欲的影响仍存在争议。本研究旨在评估通过饮食和运动实现的 WL 对肥胖患者的短期和长期食欲的影响。35 名（22 名女性）严重肥胖患者（体重指数：42.5±5.0kg/m²）接受了为期 2 年的 WL 计划，重点是饮食和运动。在基线（B）、第 4 周（W4）以及 1 年和 2 年时测量体重（BW）、心血管健康（V̇o）、食欲感受以及空腹和餐后状态下的胰岛素、活性胃饥饿素（AG）、胰高血糖素样肽 1（GLP-1）、肽 YY（PYY）和胆囊收缩素（CCK）的血浆浓度，并计算所有空腹和餐后时间点的平均值。与 B 相比，BW 在所有时间点均显著降低，V̇o（ml·kg·min）增加（第 4 周和 1 年和 2 年时分别为 3.5%、8.1%和 8.4%的 WL 和 7%、11%和 8%的增加）。基线饥饿感和平均饥饿感以及进食欲望在 1 年和 2 年均显著增加。空腹饱腹感在 W4 时显著增加，而平均评分在 1 年时降低。与 B 相比，AG 和 PYY 的平均水平显著升高，而胰岛素水平降低。GLP-1 的平均水平在 W4 时降低，CCK 在 2 年时升高。因此，在生活方式引起的 WL 后，严重肥胖患者将不得不长期应对增加的饥饿感。总之，通过饮食和运动实现的 2 年持续 WL 与增加的饥饿感和胃饥饿素浓度相关，但也与餐后饱腹感激素浓度增加相关。
