Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Centre for Obesity and Innovation, Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.
Obesity (Silver Spring). 2020 Dec;28(12):2331-2338. doi: 10.1002/oby.23011.
The purpose of this study was to examine whether the degree of ketosis, measured as plasma β-hydroxybutyrate (βHB) in fasting, was associated with changes in appetite feelings and plasma concentration of appetite-related hormones after weight loss.
A total of 87 individuals with obesity (BMI: 36.5 ± 4.0 kg/m ; age: 42.4 ± 9.7 years; 39 males) underwent 8 weeks of a very low-energy diet. Body weight/composition, plasma concentration of βHB, and appetite-related hormones (active ghrelin, active glucagon-like peptide 1 [GLP-1], total peptide YY, cholecystokinin [CCK], and insulin) and subjective appetite feelings were measured at baseline and week 9.
Participants lost 17.7 ± 4.1 kg and were ketotic (βHB: 1.24 ± 0.82 mmol/L in fasting) at week 9. A negative association was found between βHB in fasting at week 9 and changes in basal (r = -0.315, P = 0.003) and postprandial ghrelin concentration (r = -0.286, P = 0.008), and a positive association was found with the change in postprandial GLP-1 (r = 0.244, P = 0.025) and CCK (r = 0.228, P = 0.035). No association was seen between βHB in fasting and changes in peptide YY or subjective feelings of appetite.
βHB plasma concentration in fasting is associated with lower concentrations of the hunger hormone ghrelin and increased concentrations of the satiety hormones GLP-1 and CCK. Future studies should explore the molecular mechanisms by which βHB modulates the secretion of gut hormones.
本研究旨在探讨空腹时的血酮体（βHB）水平与减肥后食欲感觉和相关激素的变化是否相关。
共 87 名肥胖患者（BMI：36.5±4.0kg/m2；年龄：42.4±9.7 岁；39 名男性）接受了 8 周的极低能量饮食。在基线和第 9 周测量体重/成分、血浆βHB 浓度和食欲相关激素（活性胃饥饿素、活性胰高血糖素样肽 1[GLP-1]、总肽 YY、胆囊收缩素[CCK]和胰岛素）以及主观食欲感觉。
参与者体重减轻了 17.7±4.1kg，第 9 周时出现酮症（空腹βHB：1.24±0.82mmol/L）。第 9 周空腹时的βHB 与基础（r=-0.315，P=0.003）和餐后胃饥饿素浓度（r=-0.286，P=0.008）的变化呈负相关，与餐后 GLP-1（r=0.244，P=0.025）和 CCK（r=0.228，P=0.035）的变化呈正相关。空腹βHB 与肽 YY 或食欲主观感觉的变化无相关性。
空腹时的βHB 血浆浓度与饥饿激素胃饥饿素浓度降低和饱食激素 GLP-1 和 CCK 浓度升高有关。未来的研究应该探讨βHB 调节肠道激素分泌的分子机制。
