肥胖症患者接受减重手术后，其促尿钠排泄肽激素反应的围手术期变化。
Perioperative changes in prouroguanylin hormone response in severely obese subjects after bariatric surgery.
机构信息
Department of Surgery, Rush University, Chicago, IL.
Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Surgery. 2019 Oct;166(4):456-459. doi: 10.1016/j.surg.2019.06.037. Epub 2019 Aug 29.
BACKGROUND
Prouroguanylin is a gut hormone converted into uroguanylin in the hypothalamus. Uroguanylin induces satiety through guanylyl-cyclase-2C receptor signaling. However, little is known about the role of this hormone in regulating human food intake.
METHODS
In prospective-cohort study, prouroguanylin profile changes were determined during meal stimulation in obese patients 2 weeks before and 2 weeks after Roux-en-Y gastric bypass surgery. We also investigated whether these changes play a role in the anorexigenic effect of Roux-en-Y gastric bypass.
RESULTS
The study enrolled 8 healthy lean volunteers and 10 obese patients with type 2 diabetes. Prouroguanylin levels were postprandially decreased at 30 minutes (P = .04) and 60 minutes (P = .008) in obese patients before surgery, and they were increased at 60 minutes (P = .003), 90 minutes (P = .008), and 120 minutes (P = .009) after surgery. We observed a significant difference (P = .001) in fasting prouroguanylin levels before (8.82 ± 1.2 ng/mL) and after (6.05 ± 1.2 ng/mL) Roux-en-Y gastric bypass. Hunger ratings in the fasted state did not change after Roux-en-Y gastric bypass. Instead, subjects demonstrated significantly (P = .01) lower hunger visual analog scale scores than before Roux-en-Y gastric bypass. No correlations between circulating prouroguanylin levels and hunger perception were found before or after Roux-en-Y gastric bypass.
CONCLUSION
Prouroguanylin levels decrease after meal stimulation in obese patients, and they increase after Roux-en-Y gastric bypass, but no correlations exist with hunger visual analog scale scores.
背景
Prouroguanylin 是一种在胃激素，在丘脑被转化为尿鸟苷酸。尿鸟苷酸通过鸟苷酸环化酶-2C 受体信号诱导饱腹感。然而，关于这种激素在调节人体食物摄入中的作用知之甚少。
方法
在前瞻性队列研究中，在肥胖患者接受 Roux-en-Y 胃旁路手术前 2 周和后 2 周期间，通过餐刺激来确定 prouroguanylin 谱的变化。我们还研究了这些变化是否在 Roux-en-Y 胃旁路的厌食作用中发挥作用。
结果
该研究纳入了 8 名健康的瘦志愿者和 10 名患有 2 型糖尿病的肥胖患者。在手术前，肥胖患者的 prouroguanylin 水平在餐后 30 分钟（P =.04）和 60 分钟（P =.008）时降低，而在术后 60 分钟（P =.003）、90 分钟（P =.008）和 120 分钟（P =.009）时增加。我们观察到空腹 prouroguanylin 水平在 Roux-en-Y 胃旁路手术前后有显著差异（P =.001），分别为 8.82±1.2ng/mL 和 6.05±1.2ng/mL。Roux-en-Y 胃旁路后，空腹时的饥饿感没有改变。相反，与 Roux-en-Y 胃旁路前相比，受试者的饥饿视觉模拟评分显著降低（P =.01）。在 Roux-en-Y 胃旁路前后，均未发现循环 prouroguanylin 水平与饥饿感之间存在相关性。
结论
肥胖患者餐后刺激后 prouroguanylin 水平下降，Roux-en-Y 胃旁路后升高，但与饥饿视觉模拟评分无相关性。
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