Abstract：
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.
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.
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).
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.
NCT02649907. https://clinicaltrials.gov/ct2/show/NCT02649907.
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.
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).
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.
NCT02649907. https://clinicaltrials.gov/ct2/show/NCT02649907.
摘要：
持续的体重减轻在肥胖症中是非常期望的。虽然肠促胰岛素在调节体重中的作用是众所周知的，之前尚未研究过大量营养素特异性肠促胰岛素反应和体重减轻对该反应的影响。我们的目标是检查GLP-1，GIP，ghrelin,胰岛素，超重和肥胖受试者在减肥前后对不同常量营养素组成的膳食的饱腹感反应。
32名超重和肥胖参与者在减肥干预前后接受了膳食测试。测试餐被设计为碳水化合物(CHO)，脂肪（脂肪），或蛋白质（PRO）富集测试常量营养素特异性反应。GLP-1、GIP、体重减轻前后的ghrelin是主要结局指标。胰岛素反应和饱腹感是预定的次要终点。
GLP-1有大量营养素特异性反应模式（PRO>FAT=CHO），GIP（CHO=FAT>PRO），和胰岛素（CHO>PRO=脂肪）。在测试膳食之间,ghrelin的餐后下降没有差异。饥饿,想吃,在基线时摄入CHO(CHO>PRO=FAT)后，预期食物消耗量最高。减肥后,空腹和餐后GLP-1和胰岛素降低,同时ghrelin水平升高.然而,大量营养素特异性激素反应模式在减肥后没有改变.虽然减肥增加了饥饿感和进食欲望，大量营养素特异性差异在体重减轻后消失。较高的体重减轻与PRO诱导的GLP-1反应的较强下降相关(ρ=0.45,p=0.024,n=27)。
在超重/肥胖参与者中，激素和饱腹感都显示出大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-饱腹感联系的部分破坏，因为特别是代表冲动控制的饱腹感评分的大量营养素特异性反应模式消失了，而不是肠促胰岛素消失了。
NCT02649907。https://clinicaltrials.gov/ct2/show/NCT02649907.
32名超重和肥胖参与者在减肥干预前后接受了膳食测试。测试餐被设计为碳水化合物(CHO)，脂肪（脂肪），或蛋白质（PRO）富集测试常量营养素特异性反应。GLP-1、GIP、体重减轻前后的ghrelin是主要结局指标。胰岛素反应和饱腹感是预定的次要终点。
GLP-1有大量营养素特异性反应模式（PRO>FAT=CHO），GIP（CHO=FAT>PRO），和胰岛素（CHO>PRO=脂肪）。在测试膳食之间,ghrelin的餐后下降没有差异。饥饿,想吃,在基线时摄入CHO(CHO>PRO=FAT)后，预期食物消耗量最高。减肥后,空腹和餐后GLP-1和胰岛素降低,同时ghrelin水平升高.然而,大量营养素特异性激素反应模式在减肥后没有改变.虽然减肥增加了饥饿感和进食欲望，大量营养素特异性差异在体重减轻后消失。较高的体重减轻与PRO诱导的GLP-1反应的较强下降相关(ρ=0.45,p=0.024,n=27)。
在超重/肥胖参与者中，激素和饱腹感都显示出大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-饱腹感联系的部分破坏，因为特别是代表冲动控制的饱腹感评分的大量营养素特异性反应模式消失了，而不是肠促胰岛素消失了。
NCT02649907。https://clinicaltrials.gov/ct2/show/NCT02649907.
