Diet-induced fasting ghrelin elevation reflects the recovery of insulin sensitivity and visceral adiposity regression.
Diet-induced fasting ghrelin elevation reflects the recovery of insulin sensitivity and visceral adiposity regression.
复制标题
饮食引起的空腹生长素释放肽升高反映了胰岛素敏感性的恢复和内脏肥胖的消退。
DOI：
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发表时间：
2021
影响因子：
5.8
通讯作者：
I. Shai
中科院分区：
文献类型：
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作者：
G. Tsaban;A. Yaskolka Meir;H. Zelicha;E. Rinott;Alon Kaplan;A. Shaleṿ;A. Katz;D. Brikner;M. Blüher;U. Ceglarek;M. Stumvoll;M. Stampfer;I. Shai
旨在
较低的空腹饥饿素水平（FGL）与肥胖和代谢综合征有关。我们的目的是探讨减肥过程中FGL的动态变化及其在减肥后的代谢和肥胖相关表现。
方法
一项临床试验的二次分析，我们将腹部肥胖/血脂异常的参与者随机分为三种饮食：健康饮食指南（HDG），地中海饮食（MED）或绿色MED饮食，所有这些都与体力活动（PA）相结合。两种MED饮食都是低热量的，包括28克/天的核桃。绿色MED组进一步食用绿色茶（3-4杯/天）和Wolffia-globosa（Mankai）植物绿色奶昔。我们在基线和18个月后通过磁共振成像测量FGL和量化体脂库。
结果
在294名参与者中[体重指数=31.3kg/m2;FGL=504± 208 pg/mL;留存率=89.8%]，较低的FGL与不利的心脏代谢参数相关，如较高的内脏脂肪组织（VAT）、肝内脂肪、瘦素和血压（所有p<0.05;多变量模型）。男性（+7.3+26.6%）和女性（-9.2 +21.3%，p =0.001）之间18个月的FGL差异。在MED组之间中度和相似的体重减轻18个月后，HDG、MED和绿色MED组的FGL分别增加了1.3%、5.4%和10.5%（绿色MED与HDG相比p=0.03），性别分层分析显示仅男性发生了相似的变化。在男性中，FGL 18个月升高与胰岛素抵抗谱的有利变化和VAT回归相关，在校正相对体重减轻后（HbA 1c：r=-0.216;胰岛素抵抗的稳态模型：r=-0.154; HDL-c：r=0.147;VAT：r=-0.221;所有p<0.05）。胰岛素抵抗和VAT仍与FGL升高呈负相关，除此之外还可通过体重减轻来解释（残差回归分析;p<0.05）。
结论
饮食诱导的FGL升高可能反映了胰岛素敏感性的恢复和VAT的回归，尤其是在男性中。Green-MED饮食与更大的FGL升高相关。
AIMS
Lower fasting-ghrelin-levels (FGL) are associated with obesity and metabolic syndrome. We aimed to explore the dynamics of FGL during weight-loss and its metabolic and adiposity-related manifestations beyond weight-loss.
METHODS
A secondary analysis of a clinical trial where we randomized participants with abdominal-obesity/dyslipidemia to one of three diets: healthy-dietary-guidelines (HDG), Mediterranean diet (MED), or green-MED diet, all combined with physical activity (PA). Both MED diets were similarly hypocaloric and included 28g/day walnuts. The green-MED group further consumed green tea (3-4 cups/day) and a Wolffia-globosa (Mankai) plant green-shake. We measured FGL and quantified body fat depots by Magnetic-Resonance-Imaging at baseline and after 18-months.
RESULTS
Among 294 participants [body-mass-index=31.3kg/m 2;FGL=504±208pg/mL; retention rate=89.8%], lower FGL were associated with unfavorable cardiometabolic parameters as higher visceral-adipose-tissue (VAT), intra-hepatic fat, leptin, and blood pressure (p<0.05 for all; multivariate models). ∆FGL18-month differed between men (+7.3+26.6%) and women (-9.2+21.3%,p=0.001). After 18-months of moderate and similar weight loss among the MED-groups, FGL increased by 1.3%, 5.4%, and 10.5% in HDG, MED, and green-MED groups, respectively (p=0.03 for green-MED vs. HDG), sex-stratified analysis revealed similar changes in men only. Among men, FGL18-month elevation was associated with favorable changes in insulin resistance profile and VAT regression, after adjusting for relative weight-loss (HbA1c:r=-0.216; homeostatic-model-of insulin-resistance:r=-0.154; HDL-c:r=0.147;VAT:r=-0.221;p<0.05 for all). , Insulin resistance and VAT remained inversely related with FGL elevation, beyond which was explained by weight-loss (residual regression analyses;p<0.05).
CONCLUSIONS
Diet-induced FGL elevation may reflect insulin sensitivity recovery and VAT regression beyond weight-loss, specifically among men. Green-MED diet is associated with greater FGL elevation.