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Chakhtoura M, Mantzoros CS. Advances in physiology, design and development of novel medications changing the landscape of obesity pharmacotherapy. Metabolism 2023; 142:155531. [PMID: 36870600 DOI: 10.1016/j.metabol.2023.155531] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Affiliation(s)
- Marlene Chakhtoura
- Department of Internal Medicine, Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christos S Mantzoros
- Beth Israel Deaconess Medical Center and Boston VA Healthcare system, Harvard Medical School, Boston, MA.
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Acute consumption of a shake containing cashew and Brazil nuts did not affect appetite in overweight subjects: a randomized, cross-over study. Eur J Nutr 2021; 60:4321-4330. [PMID: 34037821 DOI: 10.1007/s00394-021-02560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Evidence from epidemiological and clinical studies suggests that nut consumption provides satiety and may contribute to the management of obesity. However, the effect of acute intake of nuts on appetite responses remains unclear. The objective of this study was to evaluate the acute effect of a shake containing 30 g of cashew nuts (Anacardium occidentale L.) and 15 g of Brazil nuts (Bertholletia excelsa H.B.K) on appetite responses in overweight subjects. METHODS This was a clinical, randomized, controlled, single-blind, cross-over, pilot study. On two non-consecutive test days, 15 subjects received a shake containing nuts, and a shake absent of nuts matched for energy and macronutrient content. Subjective appetite sensation was evaluated by visual analogue scales (VAS). Food intake was measured by weighing the lunch served at the end of each morning-test, which subjects ate ad libitum. Total energy intake was estimated by food records. This study is registered on the Brazilian Registers of Clinical Trials-ReBEC (protocol: U1111-1203-9891). RESULTS We observed no significant difference in subjective appetite sensations between the groups. Food intake at lunch, as well as energy intake throughout the day also did not differ between the treatments. CONCLUSION Our results suggest that the acute intake of a shake containing nuts was not able to enhance satiety, compared to a shake matched for energy and macronutrient content. Further studies are warranted to elucidate the satiety mechanisms of nuts intake.
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Kong H, Yu L, Gu Z, Li C, Cheng L, Hong Y, Li Z. An Innovative Short-Clustered Maltodextrin as Starch Substitute for Ameliorating Postprandial Glucose Homeostasis. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:354-367. [PMID: 33350823 DOI: 10.1021/acs.jafc.0c02828] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dietary starch is usually associated with elevated postprandial glycemic response. This is a potential risk factor of type 2 diabetes. Here, a 1,4-α-glucan branching enzyme (GBE) was employed to reassemble α-1,4 and α-1,6 glycosidic bonds in starch molecules. Structural characterization showed that GBE-catalyzed molecular reassembly created an innovative short-clustered maltodextrin (SCMD), which showed a dense internal framework along with shortened external chains. Such short-clustered molecules obstructed digestive enzymes attack and displayed dramatically reduced digestibility. Therefore, SCMD was served as a dietary starch substitute to improve postprandial glucose homeostasis. A 22.3% decrease in glycemic peak was therefore detected in ICR mice following SCMD intake (10.7 mmol/L), compared with that in the control (13.8 mmol/L). Moreover, an attenuated insulin response (40.5% lower than that in control) to SCMD intake was regarded suitable for diabetes management. These novel discoveries demonstrate that enzymatically rebuilding starch molecules may be a meaningful strategy for diabetes management.
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Affiliation(s)
- Haocun Kong
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Luxi Yu
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Zhengbiao Gu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Caiming Li
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Li Cheng
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Yan Hong
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
| | - Zhaofeng Li
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center for Food Safety and Quality Control, Jiangnan University, Wuxi 214122, China
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4
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Sertie R, Kang M, Antipenko JP, Liu X, Maianu L, Habegger K, Garvey WT. In utero nutritional stress as a cause of obesity: Altered relationship between body fat, leptin levels and caloric intake in offspring into adulthood. Life Sci 2020; 254:117764. [PMID: 32407841 PMCID: PMC8513136 DOI: 10.1016/j.lfs.2020.117764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 12/13/2022]
Abstract
AIMS Emerging evidence suggests that during gestation the in utero environment programs metabolism and can increase risk of obesity in adult offspring. Our aim was to study how alterations in maternal diets during gestation might alter body weight evolution, circulating leptin levels and caloric intake in offspring, leading to changes in body composition. MATERIALS AND METHODS We fed gestating rats either a control diet (CD), high fat diet (HFD) or an isocaloric low protein diet (LPD), and examined the repercussions in offspring fed similar diets post-weaning on birth weight, body weight evolution, body composition, insulin sensitivity, glucose tolerance and in the relationship between plasma leptin concentration and caloric intake in offspring during growth and development. KEY FINDS Offspring from dams fed LPD maintained reduced body weight with greater % lean mass and consumed fewer calories despite having leptin levels similar to controls. On the other hand, offspring from dams fed a HFD were insulin resistant and maintained increased body weight and % fat mass, while consuming more calories than controls despite elevated leptin concentrations. Therefore the uterine environment, modulated primarily through maternal nutrition, modified the relationship between circulating leptin levels, body fat, and caloric intake in the offspring, and dams fed a HFD produced offspring with excess adiposity, insulin resistance, and leptin resistance into adulthood. SIGNIFICANCE Our data indicates that in utero environmental factors affected by maternal diet program alterations in the set point around which leptin regulates body weight in offspring into adulthood contributing to obesity.
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Affiliation(s)
- Rogerio Sertie
- Department of Nutrition Sciences, University of Alabama at Birmingham, United States of America
| | - Minsung Kang
- Department of Nutrition Sciences, University of Alabama at Birmingham, United States of America.
| | - Jessica P Antipenko
- Department of Medicine, University of Alabama at Birmingham, United States of America
| | - Xiaobing Liu
- Department of Nutrition Sciences, University of Alabama at Birmingham, United States of America
| | - Lidia Maianu
- Department of Nutrition Sciences, University of Alabama at Birmingham, United States of America
| | - Kirk Habegger
- Department of Medicine, University of Alabama at Birmingham, United States of America
| | - W Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham, United States of America; Birmingham Veterans Affairs Medical Center, Birmingham, AL, United States of America
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Relationship of Body Composition Measures and Metabolic Basal Rate with Gastrointestinal Hormones in Weight Regain 5 Years After Gastric Bypass. Obes Surg 2020; 30:1536-1543. [DOI: 10.1007/s11695-019-04342-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Goes LG, da Luz Eltchechem C, Wouk J, Malfatti CRM, da Silva LA. Relationship Between Hormonal Mechanisms of Diabetes Mellitus and Hypothyroidism Post-Bariatric Surgery. Curr Diabetes Rev 2020; 16:200-203. [PMID: 31038066 DOI: 10.2174/1573399815666190417145440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 04/06/2019] [Accepted: 04/09/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Obesity, diabetes mellitus may be related to the health, the relationship and the physiological capacity of the production of thyroid hormones (TH), triiodothyronine (T3) and thyroxine (T4). OBJECTIVES The main aims of this review are to describe the relationship between obesity, appetite, weight management, hormonal mechanisms of diabetes mellitus and hypothyroidism post-bariatric surgery. METHODOLOGY An in-depth literature search was conducted to identify scientific studies, which analyzed the correlation between diabetes mellitus and hypothyroidism post-bariatric surgery. RESULTS Bariatric surgery decreases hypothyroidism, reduces the need for pharmacological action (such as levothyroxine), controls the weight and body fat and increases the sensitivity to leptin and insulin. CONCLUSION The reduction of the stomach and intestine by bariatric surgery is an evolutionary and beneficial action, because it may lead to a drastic decrease on numbers of conditions such as diabetes, obesity, hypothyroidism, and others. Thus, new studies should also focus on patients' post-operatory conditions, such as lifetime, regulation and functioning of organs after reduced nutrition, and consumption and delivery of nutrients to health maintenance.
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Affiliation(s)
- Lucas G Goes
- Department of Physical Education, Faculdade Guairaca, Guarapuava, Parana, Brazil
| | | | - Jessica Wouk
- Department of Physical Education, Universidade Estadual do Centro, Oeste, Brazil
| | - Carlos R M Malfatti
- Department of Physical Education, Universidade Estadual do Centro, Oeste, Brazil
| | - Luiz A da Silva
- Department of Physical Education, Faculdade Guairaca, Guarapuava, Parana, Brazil
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Coutinho SR, Halset EH, Gåsbakk S, Rehfeld JF, Kulseng B, Truby H, Martins C. Compensatory mechanisms activated with intermittent energy restriction: A randomized control trial. Clin Nutr 2018; 37:815-823. [DOI: 10.1016/j.clnu.2017.04.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 03/22/2017] [Accepted: 04/03/2017] [Indexed: 12/19/2022]
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Auclair N, Melbouci L, St-Pierre D, Levy E. Gastrointestinal factors regulating lipid droplet formation in the intestine. Exp Cell Res 2018; 363:1-14. [PMID: 29305172 DOI: 10.1016/j.yexcr.2017.12.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 12/22/2022]
Abstract
Cytoplasmic lipid droplets (CLD) are considered as neutral lipid reservoirs, which protect cells from lipotoxicity. It became clear that these fascinating dynamic organelles play a role not only in energy storage and metabolism, but also in cellular lipid and protein handling, inter-organelle communication, and signaling among diverse functions. Their dysregulation is associated with multiple disorders, including obesity, liver steatosis and cardiovascular diseases. The central aim of this review is to highlight the link between intra-enterocyte CLD dynamics and the formation of chylomicrons, the main intestinal dietary lipid vehicle, after overviewing the morphology, molecular composition, biogenesis and functions of CLD.
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Affiliation(s)
- N Auclair
- Research Centre, CHU Sainte-Justine and Department of Montreal, Quebec, Canada H3T 1C5; Nutrition, Université de Montréal, Montreal, Quebec, Canada H3T 1C5
| | - L Melbouci
- Research Centre, CHU Sainte-Justine and Department of Montreal, Quebec, Canada H3T 1C5; Department of Sciences and Physical Activities, UQAM, Quebec, Canada H2X 1Y4
| | - D St-Pierre
- Research Centre, CHU Sainte-Justine and Department of Montreal, Quebec, Canada H3T 1C5; Department of Sciences and Physical Activities, UQAM, Quebec, Canada H2X 1Y4
| | - E Levy
- Research Centre, CHU Sainte-Justine and Department of Montreal, Quebec, Canada H3T 1C5; Nutrition, Université de Montréal, Montreal, Quebec, Canada H3T 1C5; Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec, Quebec, Canada G1V 0A6.
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Koliaki C, Liatis S, le Roux CW, Kokkinos A. The role of bariatric surgery to treat diabetes: current challenges and perspectives. BMC Endocr Disord 2017; 17:50. [PMID: 28797248 PMCID: PMC5553790 DOI: 10.1186/s12902-017-0202-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 08/06/2017] [Indexed: 12/14/2022] Open
Abstract
Bariatric surgery is emerging as a powerful weapon against severe obesity and type 2 diabetes mellitus (T2DM). Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to treat T2DM, especially in light of accumulating evidence that surgery with gastrointestinal manipulations may result in T2DM remission (metabolic surgery). The major mechanisms mediating the weight loss-independent effects of bariatric surgery comprise effects on tissue-specific insulin sensitivity, β-cell function and incretin responses, changes in bile acid composition and flow, modifications of gut microbiota, intestinal glucose metabolism and increased brown adipose tissue metabolic activity. Shorter T2DM duration, better preoperative glycemic control and profound weight loss, have been associated with higher rates of T2DM remission and lower risk of relapse. In the short and medium term, a significant amount of weight is lost, T2DM may completely regress, and cardiometabolic risk factors are dramatically improved. In the long term, metabolic surgery may achieve durable weight loss, prevent T2DM and cancer, improve overall glycemic control while leading to significant rates of T2DM remission, and reduce total and cause-specific mortality. The gradient of efficacy for weight loss and T2DM remission comparing the four established surgical procedures is biliopancreatic diversion >Roux-en-Y gastric bypass >sleeve gastrectomy >laparoscopic adjustable gastric banding. According to recently released guidelines, bariatric surgery should be recommended in diabetic patients with class III obesity, regardless of their level of glycemic control, and patients with class II obesity with inadequately controlled T2DM despite lifestyle and optimal medical therapy. Surgery should also be considered in patients with class I obesity and inadequately controlled hyperglycemia despite optimal medical treatment.
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Affiliation(s)
- Chrysi Koliaki
- First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Carel W. le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
- Investigative Science, Imperial College London, London, UK
| | - Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine, Diabetes Centre, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Coutinho SR, With E, Rehfeld JF, Kulseng B, Truby H, Martins C. The impact of rate of weight loss on body composition and compensatory mechanisms during weight reduction: A randomized control trial. Clin Nutr 2017; 37:1154-1162. [PMID: 28479016 DOI: 10.1016/j.clnu.2017.04.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/29/2017] [Accepted: 04/10/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND & AIMS Rapid weight loss (WL) has been associated with a larger loss of fat free mass and a disproportional reduction in resting metabolic rate (RMR), but the evidence is inconclusive. We aimed to evaluate the impact of WL rate on body composition and compensatory mechanisms activated with WL (reduced RMR, increased exercise efficiency (ExEff) and appetite), both during negative and neutral energy balance (EB). METHODS Thirty-five participants with obesity were randomized to lose a similar weight rapidly (4 weeks) or gradually (8 weeks), and afterwards to maintain it (4 weeks). Body weight and composition, RMR, ExEff (10, 25 and 50 W), appetite feelings and appetite-regulating hormones (active ghrelin, cholecystokinin, total peptide YY (PYY), active glucagon-like peptide-1 and insulin), in fasting and every 30 min up to 2.5 h, were measured at baseline and after each phase. RESULTS Changes in body weight (≈9%) and composition were similar in both groups. With WL, RMR decreased and ExEff at 10 W increased significantly in the rapid WL group only. However, fasting hunger increased significantly with gradual WL only, while fasting and postprandial prospective food consumption, and postprandial hunger decreased (and postprandial fullness increased) significantly with rapid WL only. Basal total PYY, and basal and postprandial insulin decreased significantly, and similarly in both groups. After weight stabilization and no ketosis no differences between groups were found. CONCLUSIONS Despite differences while under negative EB, WL rate does not seem to have a significant impact on body composition or on compensatory mechanisms, once EB is reestablished. CLINICAL TRIAL REGISTRATION NUMBER NCT01912742 (the study was registered in clinicaltrial.gov).
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Affiliation(s)
- Sílvia Ribeiro Coutinho
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Emilie With
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jens F Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bård Kulseng
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Helen Truby
- Department of Food, Nutrition and Dietetics, Monash University, Melbourne, Australia
| | - Cátia Martins
- Obesity Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
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Elliott JA, Reynolds JV, le Roux CW, Docherty NG. Physiology, pathophysiology and therapeutic implications of enteroendocrine control of food intake. Expert Rev Endocrinol Metab 2016; 11:475-499. [PMID: 30058920 DOI: 10.1080/17446651.2016.1245140] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the increasing prevalence of obesity and its associated comorbidities, strides to improve treatment strategies have enhanced our understanding of the function of the gut in the regulation of food intake. The most successful intervention for obesity to date, bariatric surgery effectively manipulates enteroendocrine physiology to enhance satiety and reduce hunger. Areas covered: In the present article, we provide a detailed overview of the physiology of enteroendocrine control of food intake, and discuss its pathophysiologic correlates and therapeutic implications in both obesity and gastrointestinal disease. Expert commentary: Ongoing research in the field of nutrient sensing by L-cells, as well as understanding the role of the microbiome and bile acid signaling may facilitate the development of novel strategies to combat the rising population health threat associated with obesity. Further refinement of post-prandial satiety gut hormone based therapies, including the development of chimeric peptides exploiting the pleiotropic nature of the gut hormone response, and identification of novel methods of delivery may hold the key to optimization of therapeutic modulation of gut hormone physiology in obesity.
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Affiliation(s)
- Jessie A Elliott
- a Diabetes Complications Research Centre, Conway Institute of Biomedical and Biomolecular Research , University College Dublin , Dublin , Ireland
- b Department of Surgery, Trinity Centre for Health Sciences , Trinity College Dublin and St. James's Hospital , Dublin , Ireland
| | - John V Reynolds
- b Department of Surgery, Trinity Centre for Health Sciences , Trinity College Dublin and St. James's Hospital , Dublin , Ireland
| | - Carel W le Roux
- a Diabetes Complications Research Centre, Conway Institute of Biomedical and Biomolecular Research , University College Dublin , Dublin , Ireland
- c Gastrosurgical Laboratory, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Neil G Docherty
- a Diabetes Complications Research Centre, Conway Institute of Biomedical and Biomolecular Research , University College Dublin , Dublin , Ireland
- c Gastrosurgical Laboratory, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
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Gibbons C, Finlayson G, Caudwell P, Webb DL, Hellström PM, Näslund E, Blundell JE. Postprandial profiles of CCK after high fat and high carbohydrate meals and the relationship to satiety in humans. Peptides 2016; 77:3-8. [PMID: 26429068 DOI: 10.1016/j.peptides.2015.09.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 09/18/2015] [Accepted: 09/21/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT CCK is understood to play a major role in appetite regulation. Difficulties in measuring CCK have limited the potential to assess its profile in relation to food-induced satiety. Improvements in methodology and progress in theoretical understanding of satiety/satiation make it timely for this to be revisited. OBJECTIVE First, examine how physiologically relevant postprandial CCK8/33(s) profiles are influenced by fat (HF) or carbohydrate (HCHO) meals. Second, to examine relationships between postprandial CCK and profiles of satiety (hunger/fullness) and satiation (meal size). PARTICIPANTS AND DESIGN Sixteen overweight/obese adults (11 females/5 males) participated in a randomised-crossover study (46 years, 29.8 kg/m(2)) in a university research centre. Plasma was collected preprandially and for 180 min postprandially. Simultaneously, ratings of hunger/fullness were tracked for 180 min before an ad libitum lunch was provided. RESULTS CCK8/33(s) levels increased more rapidly and reached a higher peak following HF compared to HCHO breakfast (F(1,15)=14.737, p<0.01). Profiles of hunger/fullness did not differ between conditions (F(1,15)=0.505, p=0.488; F(1,15)=2.277, p=0.152). There was no difference in energy intake from the ad libitum meal (HF-3958 versus HCHO-3925 kJ; t(14)=0.201, p=0.844). CCK8/33(s) profiles were not associated with subjective appetite during early and late phases of satiety; nor was there an association between CCK8/33(s) and meal size. CONCLUSIONS These results demonstrate CCK levels were higher after HF meal compared to HCHO isocaloric meal. There was no association between CCK levels and intensity of satiety, or with meal size. Under these circumstances, CCK does not appear to play a unique independent role in satiety/satiation. CCK probably acts in conjunction with other peptides and the action of the stomach.
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Affiliation(s)
- Catherine Gibbons
- Biopsychology Group, School of Psychology, University of Leeds, Leeds, UK.
| | - Graham Finlayson
- Biopsychology Group, School of Psychology, University of Leeds, Leeds, UK
| | - Phillipa Caudwell
- Biopsychology Group, School of Psychology, University of Leeds, Leeds, UK
| | - Dominic-Luc Webb
- Department of Medical Sciences, Gastroenterology and Hepatology, Uppsala University, Uppsala, Sweden
| | - Per M Hellström
- Department of Medical Sciences, Gastroenterology and Hepatology, Uppsala University, Uppsala, Sweden
| | - Erik Näslund
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - John E Blundell
- Biopsychology Group, School of Psychology, University of Leeds, Leeds, UK
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Tack J, Deloose E, Ang D, Scarpellini E, Vanuytsel T, Van Oudenhove L, Depoortere I. Motilin-induced gastric contractions signal hunger in man. Gut 2016; 65:214-24. [PMID: 25539673 DOI: 10.1136/gutjnl-2014-308472] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/24/2014] [Indexed: 12/12/2022]
Abstract
RATIONALE Hunger is controlled by the brain, which receives input from signals of the GI tract (GIT). During fasting, GIT displays a cyclical motor pattern, the migrating motor complex (MMC), regulated by motilin. OBJECTIVES To study the relationship between hunger and MMC phases (I-III), focusing on spontaneous and pharmacologically induced phase III and the correlation with plasma motilin and ghrelin levels. The role of phase III was also studied in the return of hunger after a meal in healthy individuals and in patients with loss of appetite. FINDINGS In fasting healthy volunteers, mean hunger ratings during a gastric (62.5±7.5) but not a duodenal (40.4±5.4) phase III were higher (p<0.0005) than during phase I (27.4±4.7) and phase II (37±4.5). The motilin agonist erythromycin, but not the cholinesterase inhibitor neostigmine, induced a premature gastric phase III, which coincided with an increase in hunger scores from 29.2±7 to 61.7±8. The somatostatin analogue octreotide induced a premature intestinal phase III without a rise in hunger scores. Hunger ratings significantly correlated (β=0.05; p=0.01) with motilin plasma levels, and this relationship was lost after erythromycin administration. Motilin, but not ghrelin administration, induced a premature gastric phase III and a rise in hunger scores. In contrast to octreotide, postprandial administration of erythromycin induced a premature gastric phase III accompanied by an early rise in hunger ratings. In patients with unexplained loss of appetite, gastric phase III was absent and hunger ratings were lower. CONCLUSIONS Motilin-induced gastric phase III is a hunger signal from GIT in man.
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Affiliation(s)
- J Tack
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - E Deloose
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - D Ang
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - E Scarpellini
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - T Vanuytsel
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - L Van Oudenhove
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - I Depoortere
- Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
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Neff KJ, O'Donohoe PK, le Roux CW. Anti-inflammatory effects of gastric bypass surgery and their association with improvement in metabolic profile. Expert Rev Endocrinol Metab 2015; 10:435-446. [PMID: 30293493 DOI: 10.1586/17446651.2015.1054808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Obesity is associated with chronic inflammation and metabolic disease. Bariatric surgery offers a treatment that can effectively reduce weight and improve the metabolic function. However, the effect of bariatric surgery on chronic inflammation in obesity is under-investigated. In this expert review, the authors outline the effect of Roux-en-Y gastric bypass, the most commonly performed bariatric surgery in current practice, on the markers of inflammation. They include a discussion of the relationship between inflammation and weight loss after surgery, the interaction between these markers and metabolic disease, and the effect on adipose tissue inflammation. They also briefly explore the role of glucagon-like-peptide 1 in remediating inflammation and the changes in gut microbiota after Roux-en-Y gastric bypass, and how they may be important in inflammation.
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Affiliation(s)
- Karl J Neff
- a 1 Diabetic Complication Research Centre, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Patrick K O'Donohoe
- a 1 Diabetic Complication Research Centre, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Carel W le Roux
- a 1 Diabetic Complication Research Centre, UCD Conway Institute, University College Dublin, Dublin, Ireland
- b 2 Metabolic Medicine Research Unit, Imperial College London, Charing Cross Hospital, London, UK
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15
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Abstract
Although the stomach is often perceived as a crude, food-grinding, muscular bag, scientific breakthroughs have shown us that in the case of the stomach there is more than meets the eye. The endocrine function of the stomach is mainly exerted through the actions of ghrelin, an acylated peptide hormone that is the first known and so far most extensively studied endogenous orexigenic substance. The satiety-hunger balance is kept in check by many anorexigenic gut hormones among which is the deacylated form of ghrelin--desacyl ghrelin. The interplay of gut hormones affects the brain directly, as most gut hormones cross the blood-brain barrier and bind to their respective receptors in the central nervous system. Other hormones like obestatin and nesfatin are secreted from the stomach along with ghrelin, yet their physiological function is to be elucidated. The importance of the satiety-hunger balance can be seen in its most typical derangement--obesity. Some studies imply that ghrelin, along with other gut hormones, plays an important part in the pathophysiology of obesity. More importantly, it seems that the mechanisms by which bariatric surgery procedures induce weight loss are primarily based on changing the gut hormone levels, including ghrelin. If proven, ghrelin antagonists could be the renaissance of pharmacological obesity treatment.
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Affiliation(s)
- Davor Štimac
- Department of Gastroenterology, Clinical Hospital Centre Rijeka, School of Medicine, University of Rijeka, Rijeka, Croatia
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16
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Zhu Y, Hollis JH. Gastric emptying rate, glycemic and appetite response to a liquid meal in lean and overweight males. Int J Food Sci Nutr 2014; 65:615-20. [DOI: 10.3109/09637486.2013.854747] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Marrinan S, Emmanuel AV, Burn DJ. Delayed gastric emptying in Parkinson's disease. Mov Disord 2013; 29:23-32. [PMID: 24151126 DOI: 10.1002/mds.25708] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/30/2013] [Accepted: 09/03/2013] [Indexed: 12/16/2022] Open
Abstract
Gastrointestinal symptoms are evident in all stages of Parkinson's disease (PD). Most of the gastrointestinal abnormalities associated with PD are attributable to impaired motility. At the level of the stomach, this results in delayed gastric emptying. The etiology of delayed gastric emptying in PD is probably multifactorial but is at least partly related to Lewy pathology in the enteric nervous system and discrete brainstem nuclei. Delayed gastric emptying occurs in both early and advanced PD but is underdetected in routine clinical practice. Recognition of delayed gastric emptying is important because it can cause an array of upper gastrointestinal symptoms, but additionally it has important implications for the absorption and action of levodopa. Delayed gastric emptying contributes significantly to response fluctuations seen in people on long-term l-dopa therapy. Neurohormonal aspects of the brain-gut axis are pertinent to discussions regarding the pathophysiology of delayed gastric emptying in PD and are also hypothesized to contribute to the pathogenesis of PD itself. Ghrelin is a gastric-derived hormone with potential as a therapeutic agent for delayed gastric emptying and also as a novel neuroprotective agent in PD. Recent findings relating to ghrelin in the context of PD and gastric emptying are considered. This article highlights the pathological abnormalities that may account for delayed gastric emptying in PD. It also considers the wider relevance of abnormal gastric pathology to our current understanding of the etiology of PD.
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Affiliation(s)
- Sarah Marrinan
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom
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18
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Michalakis K, Goulis DG, Vazaiou A, Mintziori G, Polymeris A, Abrahamian-Michalakis A. Obesity in the ageing man. Metabolism 2013; 62:1341-9. [PMID: 23831443 DOI: 10.1016/j.metabol.2013.05.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 05/15/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022]
Abstract
As the population is ageing globally, both ageing and obesity are recognized as major public health challenges. The aim of this narrative review is to present and discuss the current evidence on the changes in body composition, energy balance and endocrine environment that occur in the ageing man. Obesity in the ageing man is related to changes in both body weight and composition due to alterations in energy intake and total energy expenditure. In addition, somatopenia (decreased GH secretion), late-onset hypogonadism (LOH), changes in thyroid and adrenal function, as well as changes in appetite-related peptides (leptin, ghrelin) and, most importantly, insulin action are related to obesity, abnormal energy balance, redistribution of the adipose tissue and sarcopenia (decreased muscle mass). A better understanding of the complex relationship of ageing-related endocrine changes and obesity could lead to more effective interventions for elderly men.
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Affiliation(s)
- K Michalakis
- First Department of Internal Medicine, National and Kapodestrian University of Athens, School of Medicine, "Laiko" General Hospital, Athens, Greece
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19
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Pharmacological actions of multi-target-directed evodiamine. Molecules 2013; 18:1826-43. [PMID: 23434865 PMCID: PMC6270287 DOI: 10.3390/molecules18021826] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 01/28/2013] [Accepted: 01/29/2013] [Indexed: 01/09/2023] Open
Abstract
Evodiamine, a naturally occurring indole alkaloid, is one of the main bioactive ingredients of Evodiae fructus. With respect to the pharmacological actions of evodiamine, more attention has been paid to beneficial effects in insults involving cancer, obesity, nociception, inflammation, cardiovascular diseases, Alzheimer's disease, infectious diseases and themoregulative effects. evodiamine has evolved a superior ability to bind various proteins, so we also argue that it is good starting point for multi-target drugs. This review is primarily addressed to the description of the recent advances in the biological activity studies of evodiamine, with a focus on pharmacological mechanism. The present review also includes the pharmacokinetics and the detailed exploration of target-binding properties of evodiamine in an attempt to provide a direction for further multi-target drug design.
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Falor AE, Zobel M, Kaji A, Neville A, De Virgilio C. Admission variables predictive of gangrenous cholecystitis. Am Surg 2012; 22:1648-57. [PMID: 23025944 DOI: 10.1007/s11695-012-0698-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The objective of the present study was to identify admission clinical factors associated with gangrenous cholecystitis (GC) and factors associated with conversion to open cholecystectomy. We retrospectively evaluated 391 patients over a 17-month period who underwent urgent laparoscopic cholecystectomy for a diagnosis of acute cholecystitis. Eighty-nine patients with pathologically proven GC were compared with 302 patients without GC. On multivariable logistic regression, predictors of GC included male gender, white blood cell count greater than 14,000/mm3, heart rate greater than 90 beats per minute, and sodium 135 mg/dL or less. Conversion rate to open cholecystectomy was 7.9 per cent overall, 4 per cent for non-GC, and 19 per cent for GC (odds ratio, 0.2; 95% confidence interval, 0.1 to 0.4; P<0.00001). Conversion was predicted by increasing number of days to surgery, total bilirubin, and white blood cell count. Complication rate was higher in the GC group (10.1 vs 3.6% in the acute cholecystitis group, P=0.01). The increased rate of conversion observed with surgery delay suggests that early laparoscopic cholecystectomy may be preferable in most patients.
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Affiliation(s)
- Ann E Falor
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA
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21
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Abstract
BACKGROUND Individuals with severe obesity commonly report poor body image. Improvement in body image has been found after conservative weight reduction programs as well as after bariatric surgery (gastric bypass, biliopancreatic diversion, or gastric banding). However, no studies investigating body image after laparoscopic sleeve gastrectomy (LSG) are available. METHODS Of 70 consecutive patients who planned to undergo LSG at a comprehensive obesity center, 62 patients were included in the study and evaluated before surgery. Their mean body mass index (BMI) was 51.3 kg/m(2) and the patients' mean age before surgery was 43.8 years. One-year follow-up data were obtained for 51 patients (82.3 %). Body image was assessed using the body image questionnaire (BIQ-20), and depression was assessed using the Patient Health Questionnaire (PHQ-9). RESULTS Patients reported poor body image before surgery. One year after LSG, negative evaluations of the body and perceptions of body dynamics and vitality had markedly improved, without reaching healthy levels. No correlations between body image and weight-related parameters (BMI, percentage of excess weight loss) or mood after 1 year were found. CONCLUSIONS Body image improves after LSG. This improvement might reflect changes to patients' attitudes, beliefs, and thoughts rather than real weight lost. Further studies should investigate the factors that mediate improvement of body image after bariatric surgery.
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Ellis AC, Chandler-Laney P, Casazza K, Goree LL, Gower BA. Effects of habitual diet on ethnic differences in serum total ghrelin. Endocrine 2012; 42:359-65. [PMID: 22481313 PMCID: PMC3646388 DOI: 10.1007/s12020-012-9667-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 03/22/2012] [Indexed: 11/30/2022]
Abstract
Ghrelin, an orexigenic hormone, may be involved in the etiology of obesity. African Americans (AA) experience higher obesity rates than European Americans (EA), but it is unclear whether ghrelin differs with ethnicity. This study was designed to compare ghrelin concentrations between overweight AA and EA adults in a post absorptive state, in response to a standard meal, and after 8-week habituation to diets of differing macronutrient profiles. Sixty-one overweight men and women (31 EA and 30 AA) were assigned to either a higher-carbohydrate/lower-fat diet (55% CHO, 18% PRO, 27% FAT) or a lower-carbohydrate/higher-fat diet (43% CHO, 18% PRO, 39% FAT) for 8 weeks. At baseline and week 8, participants ingested a standard liquid mixed meal. Blood was sampled before the meal and serially after ingestion to measure total ghrelin and insulin. Hunger was assessed with a visual analog scale. Composite scores for ghrelin, insulin, and hunger were calculated as area under the curve (AUC), and ghrelin suppression was calculated as the change from fasting concentration. Fasting ghrelin and ghrelin AUC were higher among EA at baseline and week 8 (p < 0.001), and these differences were not affected by diet habituation. Despite greater postprandial ghrelin suppression, EA displayed greater hunger immediately following the test meal (p < 0.05). Overweight EA displayed higher circulating ghrelin and greater ghrelin suppression compared to AA. Further study is warranted to explore the physiological basis for these ethnic differences and to determine whether they may relate to higher obesity rates among AA.
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Affiliation(s)
- Amy C Ellis
- Department of Nutrition Sciences, University of Alabama at Birmingham, 427 Webb Building, 1675 University Boulevard, Birmingham, AL 35294-3360, USA.
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23
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Changes in brain activation to food pictures after adjustable gastric banding. Surg Obes Relat Dis 2012; 8:602-8. [DOI: 10.1016/j.soard.2011.07.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 07/05/2011] [Accepted: 07/07/2011] [Indexed: 11/23/2022]
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Rieber N, Giel KE, Meile T, Enck P, Zipfel S, Teufel M. Psychological dimensions after laparoscopic sleeve gastrectomy: reduced mental burden, improved eating behavior, and ongoing need for cognitive eating control. Surg Obes Relat Dis 2012; 9:569-73. [PMID: 22784946 DOI: 10.1016/j.soard.2012.05.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 05/02/2012] [Accepted: 05/24/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity as a chronic disease has spread worldwide. Conservative treatment, especially with severe obesity, often fails. Obesity surgery has been shown to be an effective treatment. Laparoscopic sleeve gastrectomy (LSG), as a restrictive procedure, has low risks and results in good weight loss outcomes. However, to date, no studies have investigated the changes in psychological dimensions-especially concerning eating behavior and cognitive restraint-after LSG. The present study investigated, for the first time, eating behavior (cognitive restraint, disinhibition, hunger), depression, and perceived stress before and 1 year after LSG. The setting was a university hospital, comprehensive obesity center. METHODS Of 59 patients who had undergone LSG from 2008 to 2010, 40 patients were evaluated using questionnaires on eating behavior, depression, and stress, with measurements made before and 1 year after surgery. RESULTS The body mass index had decreased, on average, by 15.5 kg/m(2) 1 year after LSG (62.7% excess weight loss). The eating behaviors had changed, with patients experiencing less hunger, fewer food cravings, and decreased disinhibition. Depressive symptoms and perceived stress improved. However, the results showed high levels in the dimension of cognitive restraint of eating 1 year after LSG. CONCLUSIONS Most psychological dimensions improved as expected. The patients were less distracted by food, experienced less hunger, and were less disturbed by emotional distress. However, we found persistent cognitive restraint, reflecting an ongoing need for central eating control. Additional investigations are needed to describe the communication between the gut and brain after surgery.
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Affiliation(s)
- Nicole Rieber
- Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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25
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Ellis AC, Chandler-Laney P, Casazza K, Goree LL, McGwin G, Gower BA. Circulating ghrelin and GLP-1 are not affected by habitual diet. ACTA ACUST UNITED AC 2012; 176:1-5. [PMID: 22387702 DOI: 10.1016/j.regpep.2012.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 01/27/2012] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Ghrelin and glucagon-like peptide-1 (GLP-1) are gut hormones known to induce hunger and satiety, respectively. Current knowledge about the effects of different macronutrients on circulating ghrelin and GLP-1 comes mainly from acute test meals, whereas little is known about the effects of chronic dietary intake on gut hormone secretion. This study was designed to examine whether 8-week habituation to diets with different percentages of carbohydrate and fat would affect serum ghrelin, GLP-1, and subjective hunger in a postabsorptive state and in response to a standard liquid mixed meal. METHODS Sixty-one overweight men and women were provided all food for 8 weeks of either a higher-carbohydrate/lower-fat diet (High-CHO/Low-FAT; 55% CHO, 18% PRO, 27% FAT) or a lower-carbohydrate/higher-fat diet (Low-CHO/High-FAT; 43% CHO, 18% PRO, 39% FAT). After overnight fasts at baseline and week 8, participants consumed a standard liquid meal (7 kcals/kg, 58.6% CHO, 17.4% PRO, 24% FAT). Blood was sampled before the meal and at 15, 60, 90, 120, 180, and 240 min to determine total serum ghrelin and active GLP-1. Hunger was assessed by a visual analog scale. Mixed models were used to evaluate whether the temporal patterns of total serum ghrelin and active GLP-1 differed with diet. RESULTS Although both diet groups reported greater hunger after 8 weeks (p=0.03), circulating ghrelin and GLP-1 were not affected by acclimation to different macronutrients. CONCLUSION Habituation to different diets does not appear to influence fasting ghrelin, fasting GLP-1, or responses of these gut hormones to a standard meal.
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Affiliation(s)
- Amy C Ellis
- Department of Nutrition Sciences at the University of Alabama at Birmingham, Birmingham, AL 35294-3360, USA.
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26
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Beckman LM, Beckman TR, Sibley SD, Thomas W, Ikramuddin S, Kellogg TA, Ghatei MA, Bloom SR, le Roux CW, Earthman CP. Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass surgery. JPEN J Parenter Enteral Nutr 2011; 35:169-80. [PMID: 21378246 DOI: 10.1177/0148607110381403] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) imparts long-term weight loss, the mechanisms for which are not well understood. Changes in leptin and gastrointestinal (GI) hormones, including glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin, may contribute to the relative success of RYGB compared with conventional weight loss methods. This study evaluated changes in GI hormones and leptin post-RYGB. The study also evaluated whether GI hormones differed after a short-term dose of protein or fat. METHODS GLP-1, PYY, ghrelin, and leptin were assessed in 16 women before RYGB and up to 1 year after RYGB. Plasma was collected before and at several times after a short-term equicaloric dose of protein or fat. RESULTS GLP-1 area under the curve (AUC) increased at week 6 and 1 year in the fat beverage (FAT-BEV) group compared with baseline. PYY AUC remained elevated at 1 year in the FAT-BEV group. Ghrelin AUC decreased at week 2, week 6, and 1 year in the protein beverage (PRO-BEV) group compared with baseline. Ghrelin AUC was lower in the PRO-BEV group compared with the FAT-BEV group at week 6. Fasted leptin decreased at all visits in both groups and was lower in the FAT-BEV group compared with the PRO-BEV group at 1 year. CONCLUSIONS Changes from baseline were evident for all GI hormones and leptin; some differences were evident soon after surgery (ghrelin, leptin), whereas others were maintained long term (GLP-1, PYY, ghrelin, leptin). In response to a short-term stimulus, protein suppressed ghrelin and fat potently stimulated GLP-1 and PYY. Future work in this area is warranted.
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Affiliation(s)
- Lauren M Beckman
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
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27
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Kang KS, Yahashi S, Azuma M, Sakashita A, Shioda S, Matsuda K. Effect of intraperitoneal injection of curcumin on food intake in a goldfish model. J Mol Neurosci 2011; 45:172-6. [PMID: 20514526 DOI: 10.1007/s12031-010-9390-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 05/06/2010] [Indexed: 01/30/2023]
Abstract
Although spice compounds have several pharmacological and biochemical actions such as antioxidant activity, their physiological effects on neuropeptides related to feeding regulation are not well known. The aim of the present study was to identify the pharmacological activities of spice compounds on appetite regulation using a goldfish (Carassius auratus) model with emphasis on the role of neuropeptides. The spice compounds used in this study were curcumin, piperine, and ursolic acid. Goldfish were injected intraperitoneally with test solutions containing each spice or vehicle (including 10% dimethyl sulfoxide in saline), and the changes in food intake were measured every 15 min for 60 min. Among the tested spice compounds, curcumin was found to reduce cumulative food intake and was thus selected for further experiments. Pretreatment with capsaicin, a neurotoxin of afferent nerves, abolished the curcumin-induced decrease of food intake. Curcumin-induced anorexigenic action was also attenuated by intracerebroventricular injection of the corticotropin-releasing hormone (CRH) receptor antagonist α-helical CRH((9-41)). We also examined the expression levels of mRNA for CRH, which is a potent anorexigenic neuropeptide in goldfish, in the diencephalon at 1 h after treatment with curcumin, and found that they were increased. Therefore, the reduction of appetite induced by curcumin treatment in goldfish was suggested to be mediated by the vagal afferent and subsequently through the CRH/CRH receptor pathway.
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Affiliation(s)
- Ki Sung Kang
- Laboratory of Regulatory Biology, Graduate School of Science and Engineering, University of Toyama, 3190-Gofuku, Toyama, Toyama 930-8555, Japan
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28
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Metabolic surgery-principles and current concepts. Langenbecks Arch Surg 2011; 396:949-72. [PMID: 21870176 DOI: 10.1007/s00423-011-0834-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 08/01/2011] [Indexed: 12/19/2022]
Abstract
INTRODUCTION In the almost six decades of bariatric surgery, a variety of surgical approaches to treating morbid obesity have been developed. HISTORY AND EVOLUTION Rather than prior techniques being continually superseded by new ones, a broad choice of surgical solutions based on restrictive, malabsorptive, humoral effects, or combinations thereof, is now available. In fact, in recent years, the advent of surgically modifying human metabolism promises new approaches to ameliorate traditionally medically treated metabolic entities, i.e., diabetes, even in the non-obese. The understanding of the various metabolic effects have led to a paradigm shift from bariatric surgery as a solely weight-reducing procedure to metabolic surgery affecting whole body metabolism. CONCLUSION The bariatric surgeon now faces the challenge and opportunity of selecting the most suitable technique for each individual case. To assist in such decision-making, this review, Metabolic surgery-principles and current concepts, is presented, tracing the historical development; describing the various surgical techniques; elucidating the mechanisms by which glycemic control can be achieved that involve favorable changes in insulin secretion and insulin sensitivity, gut hormones, adipokines, energy expenditure, appetite, and preference for low glycemic index foods; as well as exploring the fascinating future potential of this new interdisciplinary field.
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Ashrafian H, Athanasiou T, Li JV, Bueter M, Ahmed K, Nagpal K, Holmes E, Darzi A, Bloom SR. Diabetes resolution and hyperinsulinaemia after metabolic Roux-en-Y gastric bypass. Obes Rev 2011; 12:e257-72. [PMID: 20880129 DOI: 10.1111/j.1467-789x.2010.00802.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The global prevalence of type 2 diabetes mellitus and impaired glucose metabolism continues to rise in conjunction with the pandemic of obesity. The metabolic Roux-en-Y gastric bypass operation offers the successful resolution of diabetes in addition to sustained weight loss and excellent long-term outcomes in morbidly obese individuals. The procedure consists of the physiological BRAVE effects: (i) Bile flow alteration; (ii) Reduction of gastric size; (iii) Anatomical gut rearrangement and altered flow of nutrients; (iv) Vagal manipulation and (v) Enteric gut hormone modulation. This operation provides anti-diabetic effects through decreasing insulin resistance and increasing the efficiency of insulin secretion. These metabolic outcomes are achieved through weight-independent and weight-dependent mechanisms. These include the foregut, midgut and hindgut mechanisms, decreased inflammation, fat, adipokine and bile metabolism, metabolic modulation, shifts in gut microbial composition and intestinal gluconeogenesis. In a small minority of patients, gastric bypass results in hyperinsulinaemic hypoglycaemia that may lead to nesidioblastosis (pancreatic beta-cell hypertrophy with islet hyperplasia). Elucidating the precise metabolic mechanisms of diabetes resolution and hyperinsulinaemia after surgery can lead to improved operations and disease-specific procedures including 'diabetes surgery'. It can also improve our understanding of diabetes pathogenesis that may provide novel strategies for the management of metabolic syndrome and impaired glucose metabolism.
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Affiliation(s)
- H Ashrafian
- The Department of Surgery and Cancer, Imperial College London, London, UK.
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30
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Punjabi M, Arnold M, Geary N, Langhans W, Pacheco-López G. Peripheral glucagon-like peptide-1 (GLP-1) and satiation. Physiol Behav 2011; 105:71-6. [PMID: 21371486 DOI: 10.1016/j.physbeh.2011.02.038] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 02/23/2011] [Indexed: 01/23/2023]
Abstract
Peripheral GLP-1 is produced by post-translational processing of pro-glucagon in enteroendocrine L-cells and is released in response to luminal nutrient (primarily carbohydrate and fat) stimulation. GLP-1 is well known for its potent insulinotropic and gluco-regulatory effects. GLP-1 receptors (GLP-1R) are expressed in the periphery and in several brain areas that are implicated in the control of eating. Both central and peripheral administration of GLP-1 have been shown to reduce food intake. Unresolved, however, is whether these effects reflect functions of endogenous GLP-1. Data collected in our laboratory indicate that in chow-fed rats: 1) Remotely controlled, intra-meal intravenous (IV) or intraperitoneal (IP) GLP-1 infusions selectively reduce meal size; 2) hindbrain GLP-1R activation is involved in the eating-inhibitory effect of IV infused GLP-1, whereas intact abdominal vagal afferents are necessary for the eating-inhibitory effect of IP, but not IV, infused GLP-1; 3) GLP-1 degradation in the liver prevents a systemic increase in endogenous GLP-1 during normal chow meals in rats; and 4) peripheral or hindbrain GLP-1R antagonism by exendin-9 does not affect spontaneous eating. Also, although our data indicate that peripheral GLP-1 can act in two different sites to inhibit eating, they argue against a role of systemic increases in endogenous GLP-1 in satiation in chow-fed rats. Therefore, further studies should examine whether a local paracrine action of GLP-1 in the intestine or and endocrine action in the hepatic-portal area is physiologically relevant for satiation.
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Affiliation(s)
- Mukesh Punjabi
- Physiology and Behaviour Laboratory, Institute of Food, Nutrition and Health, ETH Zurich, 8603 Schwerzenbach, Switzerland
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Ashrafian H, Ahmed K, Rowland SP, Patel VM, Gooderham NJ, Holmes E, Darzi A, Athanasiou T. Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer 2010; 117:1788-99. [PMID: 21509756 DOI: 10.1002/cncr.25738] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Revised: 09/08/2010] [Accepted: 09/27/2010] [Indexed: 01/09/2023]
Abstract
The worldwide epidemic of obesity and the global incidence of cancer are both increasing. There is now epidemiological evidence to support a correlation between obesity, weight gain, and some cancers. Metabolic or bariatric surgery can provide sustained weight loss and reduced obesity-related mortality. These procedures can also improve the metabolic profile to decrease cardiovascular risk and resolve diabetes in morbidly obese patients. The operations offer several physiological steps, the so-called BRAVE effects: 1) bile flow alteration, 2) reduction of gastric size, 3) anatomical gut rearrangement and altered flow of nutrients, 4) vagal manipulation and 5) enteric gut hormone modulation. Metabolic operations are also associated with a significant reduction of cancer incidence and mortality. The cancer-protective role of metabolic surgery is strongest for female obesity-related tumors; however, the underlying mechanisms may involve both weight-dependent and weight-independent effects. These include the improvement of insulin resistance with attenuation of the metabolic syndrome as well as decreased oxidative stress and inflammation in addition to the beneficial modulation of sex steroids, gut hormones, cellular energetics, immune system, and adipokines. Elucidating the precise metabolic mechanisms of cancer prevention by metabolic surgery can increase our understanding of how obesity, diabetes, and metabolic syndrome are associated with cancer. It may also offer novel treatment strategies in the management of tumor generation and growth.
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Affiliation(s)
- Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, England.
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Arck P, Handjiski B, Hagen E, Pincus M, Bruenahl C, Bienenstock J, Paus R. Is there a ‘gut-brain-skin axis’? Exp Dermatol 2010; 19:401-5. [DOI: 10.1111/j.1600-0625.2009.01060.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Beckman LM, Beckman TR, Earthman CP. Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass procedure: a review. ACTA ACUST UNITED AC 2010; 110:571-84. [PMID: 20338283 DOI: 10.1016/j.jada.2009.12.023] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 06/08/2009] [Indexed: 12/25/2022]
Abstract
Roux-en-Y gastric bypass is a well-accepted tool for the treatment of obesity and, compared to conventional weight loss methods (eg, diet and exercise) and other weight loss surgeries (eg, gastric banding), it results in considerable weight loss that is maintained long term. Although successful, the mechanisms for weight loss are not completely understood and it is thought that gastrointestinal hormones play a role. Several gastrointestinal hormones have been identified for their effects on appetite, including glucagon-like peptide-1 (GLP-1), peptide tyrosine-tyrosine (PYY), leptin, and ghrelin. This review encompasses a literature search that included 45 primary articles and shows that there are alterations in GLP-1, PYY, leptin, and ghrelin postoperatively. GLP-1 and PYY concentrations were usually found to be higher, whereas ghrelin levels were typically lower post- Roux-en-Y gastric bypass than in individuals with obesity, those who were overweight or of normal weight, and in those who underwent procedures other than Roux-en-Y gastric bypass or who achieved weight loss by lifestyle modification. An understanding of how gastrointestinal hormones change after Roux-en-Y gastric bypass may help dietetics practitioners optimize nutrition care for this patient population. A review of the literature also highlighted some research gaps that should be taken into consideration when designing future studies.
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Affiliation(s)
- Lauren M Beckman
- Department of Food Science and Nutrition, University of Minnesota, 225 Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave, St Paul, MN 55108-6099, USA
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Foxx-Orenstein AE. Gastrointestinal symptoms and diseases related to obesity: an overview. Gastroenterol Clin North Am 2010; 39:23-37. [PMID: 20202576 DOI: 10.1016/j.gtc.2009.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Obesity is a leading cause of illness and death worldwide. It is a risk factor for many common gastrointestinal symptoms and digestive disorders, including many cancers. Disruption of mechanisms that regulate appetite and satiety are fundamental to the development of obesity. Knowledge of these issues that are discussed in this article will provide the basis to develop health strategies to prevent obesity-related diseases.
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Affiliation(s)
- Amy E Foxx-Orenstein
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
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Abstract
PURPOSE OF REVIEW Regulation of body weight, food intake and appetite is complex and the gastrointestinal tract represents a central organ participating in the regulation of energy homeostasis by signaling to other tissues relevant in this context. This update will provide information regarding recent advances in the understanding of the interaction of gastrointestinal peptides with adipocytes in fat tissue and which biological effects they may exert. RECENT FINDINGS Several gastrointestinal peptides signal to their functional cognate receptors on adipocytes in white adipose tissue (WAT) thereby regulating glucose homeostasis, lipogenesis, lipolysis, free fatty acid release and may also participate in adipocyte differentiation. SUMMARY Gastrointestinal peptides emanate from enteroendocrine cells in the luminal digestive tract and are critical regulators of energy homeostasis, food intake and appetite. Recent studies have identified that gastrointestinal peptides communicate with WAT and exert their biological effects on fat cells. Fundamental understanding of gastrointestinal peptides and their interaction with adipocytes will provide future insights for the development of pharmacological targets in the treatment of obesity and insulin resistant states.
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Affiliation(s)
- Ishita D Majumdar
- Section of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts 02118-2518, USA
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Camilleri M. Peripheral mechanisms in the control of appetite and related experimental therapies in obesity. REGULATORY PEPTIDES 2009; 156:24-7. [PMID: 19409936 PMCID: PMC3898935 DOI: 10.1016/j.regpep.2009.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 04/26/2009] [Indexed: 10/20/2022]
Abstract
The function of the stomach and the gut hormonal responses to food ingestion constitute highly integrated homeostatic responses that maintain euglycemia and normal digestion. This intrinsic feedback involves vagal and hormonal mechanisms. Important signals such as GLP-1 and PYY that arise peripherally induce satiation and also delay gastric emptying or increase insulin secretion. Novel therapies are being developed to mimic or enhance these feedback mechanisms and to control appetite as a means to treat obesity.
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Affiliation(s)
- Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, United States.
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Has the human stomach passed its sell by date? Arab J Gastroenterol 2009. [DOI: 10.1016/j.ajg.2009.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Prospective study of gut hormone and metabolic changes after adjustable gastric banding and Roux-en-Y gastric bypass. Int J Obes (Lond) 2009; 33:786-95. [PMID: 19417773 PMCID: PMC2710396 DOI: 10.1038/ijo.2009.79] [Citation(s) in RCA: 244] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective The objective of this study was to quantify hormones that regulate energy and glucose homeostasis in order to establish possible mechanisms for the greater efficacy of Roux-en-Y gastric bypass (RYGB) compared with laparascopic adjustable gastric banding (LAGB) in achieving weight loss and improved insulin sensitivity. Design Longitudinal study of patients undergoing LAGB (n=15) and RYGB (n=28) who were studied prior to surgery and at 2, 12, 26 and 52 wks afterwards. Measurements Fasting blood samples were drawn at each visit. Postprandial blood samples were also obtained prior to surgery and at 26 and 52 wks. Samples were assayed for peptide YY (PYY), ghrelin, glucagon-like peptide-1 (GLP-1), glucose, insulin, leptin, thyrotropic hormone (TSH), free T4 and free T3. Results At one year there was greater weight loss in RYGB compared with LAGB patients (30% vs 15%), but final body mass index was similar (34 vs 33 kg/m2). At wk 52, area under the curve (AUC) for PYY in RYGB subjects was greater than LAGB (P<0.01). GLP-1 levels at 30 min post-meal were three-fold greater after RYGB compared with LAGB (P<0.001). Conversely, ghrelin AUC increased after LAGB at wk 52 (P<0.05) but tended to decrease after RYGB. Fasting glucose, insulin, and leptin, and HOMA-IR decreased in both groups over time but were significantly lower at wk 52 after RYGB compared with LAGB. The change in leptin correlated significantly with weight loss in LAGB (r=0.86) and RYGB (r=0.77), however, HOMA-IR correlated significantly with weight loss only in LAGB (r=0.78), and not RYGB (r=0.15). There was a significant decrease in free T3 (P<0.01) after RYGB. Conclusions Differences in levels of gut hormones may play a role in promoting greater weight loss and insulin sensitivity after RYGB compared with LAGB, however, weight loss may be limited by decreases in free T3 and leptin.
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Trends in nonalcoholic fatty liver disease-related hospitalizations in US children, adolescents, and young adults. J Pediatr Gastroenterol Nutr 2009; 48:597-603. [PMID: 19412009 DOI: 10.1097/mpg.0b013e318192d224] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To investigate temporal trends of nonalcoholic fatty liver disease (NAFLD) and obesity among hospitalized US children, adolescents, and young adults over the past 2 decades and to examine potential sex disparities in NAFLD hospitalizations. METHODS Hospitalization discharges with NAFLD or obesity were identified among children and young adults (6-25 years, weighted n = 91,687,413) from the 1986 to 2006 National Hospital Discharge Survey data. Age- and sex-specific rates and trends in hospitalizations with NAFLD and obesity were estimated. Rates were standardized to age distribution of the 2000 US Census population. Sex disparities were examined for the most recent period 2004 to 2006 (weighted n = 12,969,532). RESULTS Between 1986 to 1988 and 2004 to 2006, hospitalizations with NAFLD diagnosis increased from 0.9 to 4.3/100,000 population (P < 0.001). During the same time, hospitalizations with a diagnosis of obesity increased from 35.5 to 114.7/100,000 population (P < 0.001). During 2004 to 2006, hospitalization rates with a diagnosis of NAFLD were higher among females than among males (5.9 vs 2.7/100,000 population, P < 0.001), as were hospitalizations with a diagnosis of obesity (140.8 vs 61.5/100,000 population, P < 0.001). Obesity and diabetes were reported in 43.3% and 31.9%, respectively, of discharges with NAFLD. CONCLUSION The prevalence of NAFLD among young hospitalized patients increased in the past 2 decades, paralleling obesity-related hospitalizations. This could be a consequence of the obesity epidemic or of increased screening for liver disease.
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Trouche SG, Asuni A, Rouland S, Wisniewski T, Frangione B, Verdier JM, Sigurdsson EM, Mestre-Francés N. Antibody response and plasma Abeta1-40 levels in young Microcebus murinus primates immunized with Abeta1-42 and its derivatives. Vaccine 2008; 27:957-64. [PMID: 19114076 DOI: 10.1016/j.vaccine.2008.12.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 11/14/2008] [Accepted: 12/09/2008] [Indexed: 10/21/2022]
Abstract
We have been developing Abeta derivative vaccines with the objective to improve the safety of Abeta targeting immunotherapy. Our Abeta homologs are designed to have less direct toxicity and to produce a modified immune response compared to Abeta. In extensive mouse studies, all our vaccines have improved cognition in transgenic mice while eliciting different immune responses and reducing brain amyloid burden to a variable degree. While we are continuing to characterize these vaccines in mice, in preparation for studies in old primates and for human trials we assessed their effect in young lemur primates (n=25) that with age develop Abeta plaques and tau aggregates as seen in Alzheimer's disease. In the primates, all the peptides administered with alum adjuvant elicited a moderate to robust anti-Abeta IgM response. Abeta1-42, K6Abeta1-30 and K6Abeta1-30[E(18)E(19)] resulted in a high anti-Abeta IgG response, whereas Abeta1-30[E(18)E(19)] produced a weaker more variable IgG titer. Notably, 22 weeks after the 3rd immunization, IgM and IgG levels in derivative-vaccinated primates were similar to preimmune values whereas Abeta1-42 treated primates maintained a moderate IgG titer. The increase in antibodies that recognized Abeta1-40 often correlated with increase in Abeta1-40 in plasma, which suggests that the antibodies were binding to Abeta in vivo. Interestingly, significant transient weight gain was observed (K6Abeta1-30-, Abeta1-30[E(18)E(19)]- and Abeta1-42-treated) or a trend in the same direction (K6Abeta1-30[E(18)E(19)]-treated, adjuvant controls) following the injections. Based on these findings, we have chosen K6Abeta1-30 for immunizations in old primates as the antibody response to this vaccine was less variable compared to other Abeta derivatives. Our present findings indicate that most of our Abeta derivatives elicit a substantial antibody response in primates, and importantly this effect is reversible which enhances the safety profile of our approach.
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Affiliation(s)
- Stéphanie G Trouche
- Université Montpellier II, Montpellier F-34095, France; INSERM, U-710, Montpellier F-34095, France
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