Baboumian Shaunte, Cheney Carol, Enayet Sumiyah, Pantazatos Spiro P, Geliebter Allan
Icahn School of Medicine at Mt Sinai, New York, NY, USA.
University of North Carolina, Chapel Hill, NC, USA.
J Obes Chronic Dis. 2021;5(1):23-29. doi: 10.17756/jocd.2021-043. Epub 2021 Jun 28.
Prevalence of severe obesity continues to increase, with only bariatric surgery showing long-term efficacy for sustained weight loss. Individuals with severe obesity (vs normal weight) show greater fMRI responsivity to high energy dense (ED) vs low ED food cues and reduced responsivity post-surgery. We examined responsivity to high vs low ED cues pre-intervention in association with postsurgical (RYGB) or dietary weight-loss (dWL) change in BMI at 4 and 18 mo. Region of interest (ROI) analysis employed separate ANCOVA models; group as single factor with three levels and baseline activation and interaction with group covarying for age and gender as nuisance covariates. Significant results were identified at p < 0.1 false discovery rate (FDR) corrected, following multiple comparisons across ROIs. In the precentral gyrus (motor and motor readiness area), higher baseline activation was associated with greater %BMI reduction in RYGB at 4 and 18 mo and less %BMI reduction in dWL at 4 mo (p = 0.006 uncorrected, P < 0.1 FDR corrected). The findings show opposite directionality in predicting change in BMI for RYGB vs. dWL from responsivity to high vs low ED food cues in the precentral gyrus. Greater baseline motor planning to ingest high ED foods may be associated with reduced weight loss in dWL, and with greater weight loss in RYGB due to neuromodulatory effects of surgery.
重度肥胖的患病率持续上升，只有减肥手术显示出长期有效的持续减重效果。重度肥胖个体（与正常体重个体相比）在功能磁共振成像（fMRI）中对高能量密度（ED）食物线索的反应性高于低ED食物线索，且术后反应性降低。我们在干预前检查了对高ED与低ED线索的反应性，并将其与4个月和18个月时手术后（胃旁路手术[RYGB]）或饮食减重（dWL）导致的体重指数（BMI）变化相关联。感兴趣区域（ROI）分析采用单独的协方差分析模型；将组作为单因素，有三个水平，将基线激活以及与组的相互作用作为年龄和性别的干扰协变量进行协变分析。在对多个ROI进行多重比较后，在错误发现率（FDR）校正p<0.1时确定了显著结果。在中央前回（运动和运动准备区域），较高的基线激活与RYGB组在4个月和18个月时更大的BMI降低百分比相关，而与dWL组在4个月时较小的BMI降低百分比相关（未校正p = 0.006，FDR校正P<0.1）。研究结果表明，中央前回对高ED与低ED食物线索的反应性在预测RYGB与dWL的BMI变化方面呈现相反的方向性。对摄入高ED食物有更大的基线运动规划可能与dWL组体重减轻减少有关，而由于手术的神经调节作用，与RYGB组体重减轻增加有关。
