在没有代谢疾病的超重和肥胖人群中，体重减轻并没有改变激素和饱腹感对宏量营养素的特异性反应 - 一项临床试验的结果。
Weight loss did not modify macronutrient specific response of hormones and satiety in overweight and obese people without metabolic disease - results from a clinical trial.
机构信息
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinical Research Unit, 10117, Berlin, Germany.
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany.
出版信息
Clin Nutr. 2022 Apr;41(4):948-957. doi: 10.1016/j.clnu.2022.02.004. Epub 2022 Feb 19.
BACKGROUND & AIMS: Sustained weight loss is highly desirable in obesity. Although the role of incretins in the regulation of body weight is well known, macronutrient specific incretin response and the effects of weight loss on this response have not been investigated before. We aimed to examine GLP-1, GIP, ghrelin, insulin, and satiety response to meals with different macronutrient composition in overweight and obese subjects before and after weight loss.
METHODS
32 overweight and obese participants underwent meal tests before and after weight loss intervention. Test meals were designed to be either carbohydrate (CHO), fat (FAT), or protein (PRO) enriched to test macronutrient specific response. Macronutrient specific response of GLP-1, GIP, and ghrelin before and after weight loss were the primary outcome measures. Response of insulin and satiety were predefined secondary endpoints.
RESULTS
There were macronutrient specific response patterns of GLP-1 (PRO>FAT=CHO), GIP (CHO=FAT>PRO), and insulin (CHO>PRO=FAT). Postprandial decline of ghrelin did not differ between the test meals. Hunger, desire to eat, and prospective food consumption were highest after CHO intake (CHO>PRO=FAT) at baseline. After weight loss, fasting and postprandial GLP-1 and insulin were reduced while concomitant ghrelin levels were increased. However, the macronutrient specific hormonal response pattern did not change after weight loss. While weight loss increased hunger and desire to eat, the macronutrient specific differences were lost after weight reduction. Higher weight loss was associated with a stronger decline of PRO induced GLP-1 response (ρ = 0.45, p = 0.024, n = 27).
CONCLUSIONS
Both hormones and satiety showed a macronutrient specific response in overweight/obese participants with a possibly favorable role of protein. However, weight loss may cause a partial disruption of this hormone-satiety-connection as macronutrient specific response pattern of satiety scores representing impulse control in particular but not incretins disappeared.
TRIAL REGISTRATION
NCT02649907. https://clinicaltrials.gov/ct2/show/NCT02649907.
背景与目的
在肥胖症中，持续的体重减轻是非常理想的。尽管肠促胰岛素在调节体重方面的作用是众所周知的，但以前尚未研究过宏量营养素特异性肠促胰岛素反应以及体重减轻对这种反应的影响。我们旨在研究超重和肥胖受试者在体重减轻前后不同宏量营养素组成的膳食对 GLP-1、GIP、ghrelin、胰岛素和饱腹感的影响。
方法
32 名超重和肥胖参与者在体重减轻干预前后接受了膳食测试。测试餐旨在富含碳水化合物（CHO）、脂肪（FAT）或蛋白质（PRO），以测试宏量营养素的特异性反应。GLP-1、GIP 和 ghrelin 的宏量营养素特异性反应是主要的观察终点。胰岛素和饱腹感的反应是预先设定的次要终点。
结果
GLP-1（PRO>FAT=CHO）、GIP（CHO=FAT>PRO）和胰岛素（CHO>PRO=FAT）存在宏量营养素特异性反应模式。餐后 ghrelin 的下降在测试餐之间没有差异。在基线时，CHO 摄入后饥饿感、食欲和预期食物摄入量最高（CHO>PRO=FAT）。体重减轻后，空腹和餐后 GLP-1 和胰岛素降低，同时伴随 ghrelin 水平升高。然而，体重减轻后宏量营养素特异性激素反应模式并未改变。虽然体重减轻增加了饥饿感和食欲，但在减轻体重后，宏量营养素的特异性差异消失了。更高的体重减轻与 PRO 诱导的 GLP-1 反应下降幅度更大相关（ρ=0.45，p=0.024，n=27）。
结论
超重/肥胖参与者的激素和饱腹感均表现出宏量营养素特异性反应，蛋白质可能具有有利作用。然而，体重减轻可能会导致这种激素-饱腹感连接的部分中断，因为代表冲动控制的特定饱腹感评分的宏量营养素特异性反应模式消失，而肠促胰岛素并没有消失。
试验注册
NCT02649907。https://clinicaltrials.gov/ct2/show/NCT02649907。
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