超重或肥胖人群通过热量限制、运动或两者结合减肥后空腹时与食欲相关的肠道激素反应：一项荟萃分析。
Fasting appetite-related gut hormone responses after weight loss induced by calorie restriction, exercise, or both in people with overweight or obesity: a meta-analysis.
作者信息
Jin Zhuoxiu, Li Jiajin, Thackray Alice E, Shen Tonghui, Deighton Kevin, King James A, Stensel David J
机构信息
National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom.
National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom.
出版信息
Int J Obes (Lond). 2025 Feb 10. doi: 10.1038/s41366-025-01726-4.
OBJECTIVES
Altered appetite-related gut hormone concentrations may reflect a physiological adaptation facilitating weight regain after weight loss. This review investigates hormonal changes after weight loss achieved through calorie restriction (CR), exercise (EX), or both combined (CREX).
METHODS
A systematic search of PubMed (MEDLINE), EMBASE, SPORTDiscus, Cochrane Library, Web of Science, and ClinicalTrials.gov was conducted to identify randomised controlled trials (RCTs) and non-RCTs reporting in a fasting state either pre- and post-intervention appetite-related hormone concentrations or the changes therein after weight loss. The hormones examined were ghrelin, peptide tyrosine tyrosine (PYY), glucagon-like peptide -1 (GLP-1), and cholecystokinin (CCK), in their total and/or active form. Standardised mean differences (SMD) were extracted as the effect size.
RESULTS
127 studies were identified: 19 RCTs, 108 non-RCTs, 1305 and 4725 participants, respectively. In response to weight loss induced by CR, EX or CREX, the meta-analysis revealed an increase in total ghrelin from both RCTs (SMD: 0.55, 95% CI: 0.07-1.04) and non-RCTs (SMD: 0.24, 95% CI: 0.14-0.35). A decrease in acylated ghrelin was identified for RCTs (SMD: -0.58, 95% CI: -1.09 to -0.06) but an increase was observed for non-RCTs (SMD: 0.15, 95% CI: 0.03 to 0.27). Findings also revealed a decrease in PYY (total PYY: SMD: -0.17, 95%CI: -0.28 to -0.06; PYY: SMD: -0.17, 95%CI: -0.32 to -0.02) and active GLP-1 (SMD: -0.16, 95% CI: -0.28 to -0.05) from non-RCTs. Changes in hormones did not differ among the three interventions when controlling for weight loss. Meta-regression indicated that greater weight loss was associated with a greater increase in total ghrelin.
CONCLUSIONS
Weight loss induced by CR, EX, or CREX elicits an increase in total ghrelin, but varied responses in other appetite-related hormones. The extent of weight loss influences changes in appetite-related gut hormone concentrations.
目的
与食欲相关的肠道激素浓度改变可能反映了一种生理适应性，有助于体重减轻后体重的恢复。本综述调查了通过热量限制（CR）、运动（EX）或两者结合（CREX）实现体重减轻后的激素变化。
方法
对PubMed（MEDLINE）、EMBASE、SPORTDiscus、Cochrane图书馆、科学网和ClinicalTrials.gov进行系统检索，以确定在空腹状态下报告干预前后食欲相关激素浓度或体重减轻后激素浓度变化的随机对照试验（RCT）和非随机对照试验（non-RCT）。所检测的激素为胃饥饿素、肽YY（PYY）、胰高血糖素样肽-1（GLP-1）和胆囊收缩素（CCK）的总量和/或活性形式。提取标准化均数差（SMD）作为效应量。
结果
共识别出127项研究：分别为19项RCT、108项非RCT，参与者分别为1305名和4725名。对CR、EX或CREX引起的体重减轻的反应，荟萃分析显示，RCT（SMD：0.55，95%CI：0.07-1.0）和非RCT（SMD：0.24，95%CI：0.14-0.35）中总胃饥饿素均增加。RCT中酰化胃饥饿素降低（SMD：-0.58，95%CI：-1.09至-0.06），但非RCT中观察到增加（SMD：0.15，95%CI：0.03至0.27）。研究结果还显示，非RCT中PYY（总PYY：SMD：-0.17，95%CI：-0.28至-0.06；PYY：SMD：-0.17，95%CI：-0.32至-0.02）和活性GLP-1（SMD：-0.16，95%CI：-0.28至-0.05）降低。在控制体重减轻时，三种干预措施之间的激素变化没有差异。Meta回归表明，更大程度的体重减轻与总胃饥饿素的更大增加相关。
结论
CR、EX或CREX引起的体重减轻会导致总胃饥饿素增加，但其他与食欲相关的激素反应各异。体重减轻的程度会影响与食欲相关的肠道激素浓度的变化。
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