Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil; Practice and Eating Behaviour Laboratory - PrátiCA, University of São Paulo, Brazil.
Departament of Nutrition, Institute of Health Sciences, Federal University of the Triângulo Mineiro, Brazil; Practice and Eating Behaviour Laboratory - PrátiCA, University of São Paulo, Brazil.
Physiol Behav. 2019 Jul 1;206:252-258. doi: 10.1016/j.physbeh.2019.03.013. Epub 2019 Mar 17.
BACKGROUND & AIMS: Women with polycystic ovary syndrome (PCOS) have greater predisposition to obesity, but the mechanisms are still unknown. Hyperinsulinemia, insulin resistance and low levels of ghrelin are common in this group. For the purposes of the present study, it was assumed that such changes could have an influence on hunger. This study aimed to assess the hunger pattern before and after an ad libitum meal and the association between insulin and plasma ghrelin with hunger perception in women with obesity, with and without PCOS.
This cross-sectional study included 53 women with obesity, 30 with PCOS, and 23 controls (with obesity but without PCOS). Insulin, ghrelin, glucose and subjective ratings of hunger (by 100 mm visual analogue scales) were analyzed in a fasting state, preprandially at 12:00 before the ad libitum meal, and postprandially 15, 45, 75 and 135 min after the beginning of the ad libitum meal.
There was a significant increase in hunger one hour after the beginning of the ad libitum meal (75 min) in the PCOS group (p = .01) compared to 15 min, whereas this only occurred after 135 min in the control group (2 h later). The usual energy intake adjusted by the intra-individual variability was higher in the PCOS group than in the control group (2309 ± 461 kcal·d × 2124 ± 480 kcal·d; p = .04). The concentrations of insulin and ghrelin, in both preprandial and postprandial periods, were not associated with the perception of hunger.
Women with obesity and PCOS had an earlier return of hunger in the postprandial period after an ad libitum meal, but there was not associated with postprandial ghrelin and insulin levels.
患有多囊卵巢综合征（PCOS）的女性更容易肥胖，但具体机制尚不清楚。该群体中常出现高胰岛素血症、胰岛素抵抗和生长激素释放肽水平降低。基于本研究，假设这些变化可能会影响饥饿感。本研究旨在评估肥胖女性（伴或不伴 PCOS）在随意进食前后的饥饿模式，以及胰岛素和血浆生长激素释放肽与饥饿感之间的关系。
本横断面研究纳入了 53 名肥胖女性，30 名 PCOS 女性和 23 名对照者（肥胖但无 PCOS）。分析了空腹状态、随意进食前 12：00 的预餐时、随意进食后 15、45、75 和 135 分钟的胰岛素、生长激素释放肽、血糖和饥饿感（通过 100mm 视觉模拟量表评估）。
与 15 分钟相比，PCOS 组在随意进食后 1 小时（75 分钟）饥饿感显著增加（p=0.01），而对照组仅在 135 分钟后（2 小时后）才出现这种情况。PCOS 组的习惯性能量摄入（通过个体内变异性进行调整）高于对照组（2309±461 kcal·d×2124±480 kcal·d；p=0.04）。在预餐和餐后期间，胰岛素和生长激素释放肽的浓度与饥饿感无关。
随意进食后，肥胖伴 PCOS 的女性在餐后更早地出现饥饿感，但与餐后生长激素释放肽和胰岛素水平无关。
