Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery.
Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery.
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DOI：
10.1056/nejmoa012908
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发表时间：
2002-05-23
影响因子：
158.5
通讯作者：
Purnell, JQ
中科院分区：
文献类型：
--
作者：
Cummings, DE;Weigle, DS;Purnell, JQ
背景：减肥会引起食欲和能量消耗的变化，从而促进体重回升。Ghrelin是一种荷尔蒙，可以增加啮齿动物和人类的食物摄入量。如果循环中的Ghrelin参与了对减肥的适应性反应，它的水平应该会随着节食而上升。由于胃促生长素主要由胃产生，胃旁路手术后的体重减轻可能伴随着胃促生长素的分泌受损。方法：我们测定了13名肥胖者在6个月的减肥饮食计划前后的24小时血浆胃促生长素水平、体成分、胰岛素水平、瘦素水平和胰岛素敏感性。同时测定了5例胃旁路手术后体重减轻的受试者和10名正常体重的受试者的24小时胃促生长素水平；13名参加饮食计划的肥胖者中有5名与胃旁路手术组的受试者相匹配，并作为肥胖对照组。饮食诱导的体重下降17%与24小时胃促生长素曲线下面积增加24%有关(P=0.006)。相比之下，尽管胃旁路手术后体重减轻了36%，但胃旁路组的胃促生长素曲线下面积比正常体重对照组低77%(P
Background: Weight loss causes changes in appetite and energy expenditure that promote weight regain. Ghrelin is a hormone that increases food intake in rodents and humans. If circulating ghrelin participates in the adaptive response to weight loss, its levels should rise with dieting. Because ghrelin is produced primarily by the stomach, weight loss after gastric bypass surgery may be accompanied by impaired ghrelin secretion.Methods: We determined the 24-hour plasma ghrelin profiles, body composition, insulin levels, leptin levels, and insulin sensitivity in 13 obese subjects before and after a six-month dietary program for weight loss. The 24-hour ghrelin profiles were also determined in 5 subjects who had lost weight after gastric bypass and 10 normal-weight controls; 5 of the 13 obese subjects who participated in the dietary program were matched to the subjects in the gastric-bypass group and served as obese controls.Results: Plasma ghrelin levels rose sharply shortly before and fell shortly after every meal. A diet-induced weight loss of 17 percent of initial body weight was associated with a 24 percent increase in the area under the curve for the 24-hour ghrelin profile (P=0.006). In contrast, despite a 36 percent weight loss after gastric bypass, the area under the curve for the ghrelin profile in the gastric-bypass group was 77 percent lower than in normal-weight controls (P