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.
Surgery. 2019 Oct;166(4):456-459. doi: 10.1016/j.surg.2019.06.037. Epub 2019 Aug 29.
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.
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.
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.
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.
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。
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。
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。
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。
