Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, 55 Fruit st, Boston, MA 02114, USA.
Division of Pediatric Endocrinology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit st, Boston, MA 02114, USA.
Nutrients. 2022 Jul 26;14(15):3054. doi: 10.3390/nu14153054.
With the growing prevalence of severe obesity in adolescents, sleeve gastrectomy (SG), a type of metabolic bariatric surgery (MBS), is increasingly being performed at a younger age. Data regarding changes in homeostatic and hedonic appetite following SG are conflicting in adults, with some studies showing no change and others showing a decrease in appetite. Data evaluating the effect of SG on appetite during adolescence, when appetite is more plastic, are currently lacking.
To evaluate appetite changes one year after SG in adolescents with obesity vs. in non-surgical controls (NS).
Thirty-nine subjects 13-21 years old with severe obesity were followed for a year; 19 underwent SG, and 20 were followed without surgery. Subjects had fasting blood tests for appetite-regulating hormones and completed a visual analog scale for appetite assessment (VAS).
The SG group had a decrease in body mass index (BMI) at one-year (baseline: 48.2 ± 1.7 kg/m; one-year follow-up: 42.6 ± 1.0 kg/m ( ≤ 0.0001)). No within- or between-group differences were noted in the one-year change in appetite in the SG and NS groups. After SG, fasting ghrelin decreased ( ≤ 0.0001); however, no changes were noted in peptide YY (PYY) levels. Changes in one homeostatic appetite measure following SG were inversely associated with changes in fasting PYY (r = -0.583, = 0.011). Appetite changes were not associated with weight loss or final BMI.
There were no changes in appetite measures one-year after SG from pre-surgery levels in adolescents with obesity, and appetite changes were not associated with changes in BMI. It is important to evaluate the impact of long-term appetite changes, if any, on weight loss after SG.
随着青少年重度肥胖症的日益流行，袖状胃切除术（SG）作为一种代谢减重手术（MBS），在越来越年轻的年龄进行。关于 SG 后体内平衡和享乐性食欲变化的数据在成年人中存在争议，一些研究表明食欲没有变化，而另一些研究则表明食欲下降。目前缺乏评估 SG 在青少年时期（食欲更具可塑性）对食欲影响的数据。
评估肥胖青少年 SG 后 1 年与非手术对照组（NS）的食欲变化。
39 名 13-21 岁的重度肥胖青少年随访 1 年；其中 19 名接受 SG，20 名未接受手术。在空腹状态下检测食欲调节激素，并使用视觉模拟量表（VAS）评估食欲。
SG 组在 1 年内体重指数（BMI）下降（基线：48.2 ± 1.7 kg/m；1 年随访：42.6 ± 1.0 kg/m（≤0.0001））。SG 组和 NS 组在 1 年内食欲变化无组内或组间差异。SG 后，空腹 ghrelin 降低（≤0.0001）；然而，PYY 水平无变化。SG 后，1 种体内平衡食欲测量的变化与空腹 PYY 的变化呈负相关（r=-0.583， =0.011）。食欲变化与体重减轻或最终 BMI 无关。
在肥胖青少年中，SG 后 1 年食欲测量值与术前水平相比没有变化，且食欲变化与 BMI 变化无关。评估 SG 后长期食欲变化（如果有）对体重减轻的影响非常重要。
