Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AL, Canada.
Division of Endocrinology, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Clin Endocrinol (Oxf). 2020 Nov;93(5):579-589. doi: 10.1111/cen.14279. Epub 2020 Jul 20.
The effects of dietary macronutrients on orexigenic and anorexigenic hormones in children are poorly understood.
To explore effects of varying dietary macronutrients on appetite-regulating hormones [acyl ghrelin (AG) and desacyl ghrelin (DAG), glucagon-like peptide 1 (GLP-1), peptide tyrosine tyrosine (PYY) and insulin] in children with PWS and healthy children (HC).
Randomized, cross-over experiments compared two test diets [high protein-low carbohydrate (HP-LC) and high protein-low fat (HP-LF)] to a STANDARD meal (55% carbohydrate, 30% fat, 15% protein). Experiment 1 included ten children with PWS (median age 6.63 years; BMI z 1.05); experiment 2 had seven HC (median age 12.54 years; BMI z 0.95). Blood samples were collected at baseline and at 60-minute intervals for 4 hours. Independent linear mixed models were adjusted for age, sex and BMI z-score.
Fasting and post-prandial AG and DAG concentrations are elevated in PWS children; the ratio of AG/DAG is normal. Food consumption reduced AG and DAG concentrations in both PWS and HC. GLP-1 levels were higher in PWS after the HP-LC and HP-LF meals than the STANDARD meal (P = .02-0.04). The fasting proinsulin to insulin ratio (0.08 vs 0.05) was higher in children with PWS (P = .05) than in HC. Average appetite scores in HC declined after all three meals (P = .02) but were lower after the HP-LC and HP-LF meals than the STANDARD meal.
Altered processing of proinsulin and increased GLP-1 secretion in children with PWS after a high protein meal intake might enhance satiety and reduce energy intake.
人们对于宏量营养素对儿童食欲调节激素的影响知之甚少。
探索不同的膳食宏量营养素对患有小胖威利综合征（PWS）和健康儿童（HC）的食欲调节激素[酰基胃饥饿素（AG）和脱酰基胃饥饿素（DAG）、胰高血糖素样肽 1（GLP-1）、肽 YY（PYY）和胰岛素]的影响。
随机交叉实验比较了两种测试饮食[高蛋白-低碳水化合物（HP-LC）和高蛋白-低脂肪（HP-LF）]与标准餐（55%碳水化合物、30%脂肪、15%蛋白质）的效果。实验 1 纳入了 10 名患有 PWS 的儿童（中位年龄 6.63 岁；BMI z 1.05）；实验 2 纳入了 7 名 HC（中位年龄 12.54 岁；BMI z 0.95）。在 4 小时内，每隔 60 分钟采集一次基线和餐后血液样本。采用独立线性混合模型调整年龄、性别和 BMI z 评分。
PWS 儿童的空腹和餐后 AG 和 DAG 浓度升高；AG/DAG 比值正常。进食会降低 PWS 和 HC 儿童的 AG 和 DAG 浓度。与标准餐相比，HP-LC 和 HP-LF 餐后 PWS 儿童的 GLP-1 水平更高（P=.02-0.04）。PWS 儿童的空腹胰岛素原与胰岛素的比值（0.08 比 0.05）高于 HC（P=.05）。HC 儿童在所有三餐后的平均食欲评分均下降（P=.02），但 HP-LC 和 HP-LF 餐后的评分低于标准餐。
PWS 儿童高蛋白餐后胰岛素原处理异常和 GLP-1 分泌增加可能会增强饱腹感并减少能量摄入。
