The role of postprandial releases of insulin and incretin hormones in meal-induced satiety - effect of obesity and weight reduction
The role of postprandial releases of insulin and incretin hormones in meal-induced satiety - effect of obesity and weight reduction
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DOI：
10.1038/sj.ijo.0801655
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发表时间：
2001-08-01
影响因子：
4.9
通讯作者：
Astrup, A
中科院分区：
文献类型：
--
作者：
Verdich, C;Toubro, S;Astrup, A
背景：既往研究表明，肥胖受试者肠道饱腹感激素胰高血糖素样肽-1（GLP-1）的分泌减弱。目的：比较肥胖和瘦男性受试者中GLP-1和葡萄糖依赖性促胰岛素多肽（GIP）的膳食诱导反应，研究肥胖受试者体重大幅减轻的效果，并寻找这些激素与随意食物摄入之间的关联。方法：血浆浓度在摄入 2.5 MJ 固体测试餐之前以及之后 180 分钟内每 30 分钟测量一次肠道激素和食欲感觉。通过闪烁扫描估计胃排空。测试餐后3小时随意提供午餐。受试者：19名非糖尿病肥胖男性（体重指数（BMI）34.1 -43.8 kg/m(2)）和12名瘦男性（BMI 20.4-24.7 kg/m(2)）。所有肥胖受试者在平均体重稳定减轻 18.8 kg 后均进行了重新检查 (95% CI 14.4 -23.2)。 结果：与瘦受试者相比，肥胖受试者在减肥前后 GLP-1 反应曲线下总面积 (AUC(total.GLP-1)) 较低 (P < 0.05)，尽管减肥使反应从瘦受试者的 80% 提高到 88% (P = 0.003）。肥胖和瘦受试者的 GIP 反应相似。然而，体重减轻后，AUC（总GIP）和AUC（增量）（GIP）均降低（P < 0.05）。在所有组中，AUC（增量，GIP）与随后随意进餐的能量摄入之间观察到负相关。在瘦受试者中，随意的能量摄入很大程度上是通过前一餐的胰岛素反应来预测的（r(2) = 0.67，P = 0.001）。 结论：我们的研究证实了之前的研究结果，即严重肥胖受试者餐后 GLP-1 反应降低。体重减轻后，肥胖受试者的 GLP-1 反应明显上升到肥胖受试者和瘦受试者之间的水平。数据表明，餐后胰岛素和 GIP 反应是短期食欲调节的关键因素。
BACKGROUND: Previous studies have indicated that the secretion of the intestinal satiety hormone glucagon-like peptide-1 (GLP-1) is attenuated in obese subjects.OBJECTIVE: To compare meal-induced response of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) in obese and lean male subjects, to investigate the effect of a major weight reduction in the obese subjects, and to look for an association between these hormones and ad libitum food intake.METHOD: Plasma concentrations of intestinal hormones and appetite sensations were measured prior to, and every 30 min for 180 min after, ingestion of a 2.5 MJ solid test meal. Gastric emptying was estimated scintigraphically. An ad libitum lunch was served 3h after the test meal.SUBJECTS: Nineteen non-diabetic obese (body mass index (BMI) 34.1 -43.8 kg/m(2)) and 12 lean (BMI 20.4-24.7 kg/m(2)) males. All obese subjects were re-examined after a mean stabilised weight loss of 18.8 kg (95% CI 14.4 -23.2).RESULTS: Total area under the GLP-1 response curve (AUC(total.GLP-1)) was lower in obese before and after the weight loss compared to lean subjects (P < 0.05), although weight loss improved the response from 80 to 88% of that of the lean subjects (P = 0.003). The GIP response was similar in obese and lean subjects. However, after the weight loss both AUC(total.GIP) and AUC(incremental),(GIP) were lowered (P < 0.05). An inverse correlation was observed between AUC(incremental, GIP) and energy intake at the subsequent ad libitum meal in all groups. In lean subjects ad libitum energy intake was largely predicted by the insulin response to the preceding meal (r(2) = 0.67, P = 0.001).CONCLUSION: Our study confirmed previous findings of a reduced postprandial GLP-1 response in severely obese subjects. Following weight reduction, GLP-1 response in the obese subjects apparently rose to a level between that of obese and lean subjects. The data suggests that postprandial insulin and GIP responses are key players in short-term appetite regulation.