Obesity Research Group, Department of Clinical and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Centre of Obesity and Innovation (ObeCe), Clinic of Surgery, St. Olav University Hospital, Trondheim, Norway.
Obesity (Silver Spring). 2023 Feb;31(2):399-411. doi: 10.1002/oby.23655. Epub 2022 Dec 19.
The aim of this study was to compare changes in gastrointestinal hormones and appetite ratings after a similar weight loss induced by a very low-energy diet alone or in combination with sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).
Patients with severe obesity scheduled for SG (n = 15) and RYGB (n = 14) and 15 controls (very low-energy diet alone) were recruited. Body weight/composition, plasma concentrations of ß-hydroxybutyric acid, acylated ghrelin, total glucagon-like peptide-1, total peptide YY, cholecystokinin, and ratings of hunger, fullness, desire to eat, and prospective food consumption were measured pre- and postprandially, before and after 10 weeks of intervention.
Changes in body weight/composition and level of ketosis were similar across groups. In SG and RYGB, basal and postprandial acylated ghrelin declined, and postprandial glucagon-like peptide-1 increased, both significantly more compared with controls. Postprandial peptide YY increased in all groups. Overall, postprandial hunger decreased, and postprandial fullness increased. But ratings of desire to eat and prospective food consumption were more favorable after both surgeries compared with controls.
Weight loss with SG and RYGB leads to more favorable changes in gastrointestinal hormones compared with diet alone, although ratings of appetite were reduced across all groups.
本研究旨在比较单纯极低能量饮食与袖状胃切除术（SG）或胃旁路术（RYGB）联合治疗后，胃肠道激素和食欲评分的变化。
招募了 15 名计划接受 SG 和 14 名 RYGB 的严重肥胖患者以及 15 名对照者（单纯极低能量饮食）。在干预前和 10 周后，在餐前和餐后，测量体重/成分、β-羟丁酸、酰化 ghrelin、总胰高血糖素样肽-1、总肽 YY、胆囊收缩素、饥饿、饱腹感、进食欲望和预期食物摄入量的评分。
各组体重/成分和酮症水平的变化相似。在 SG 和 RYGB 中，基础和餐后酰化 ghrelin 下降，餐后胰高血糖素样肽-1 增加，与对照组相比均有显著差异。所有组的餐后肽 YY 均增加。总的来说，餐后饥饿感减轻，餐后饱腹感增加。但与对照组相比，两种手术后的食欲评分和预期食物摄入量都更有利。
与单纯饮食相比，SG 和 RYGB 减肥导致胃肠道激素更有利的变化，尽管所有组的食欲评分都降低了。
