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1.
Medicine (Baltimore) ; 99(14): e19610, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243385

RESUMO

BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) refers to one of the common postoperative complications. Acupuncture can facilitate the recovery of PGD, whereas no therapeutic schedule of acupuncture has been internationally recognized for treating PGD. In the present study, a scientific trial protocol has been proposed to verify the feasibility of acupuncture in treating gastrointestinal dysfunction after laparoscopic cholecystectomy under general anesthesia. We conduct this protocol to investigate whether acupuncture recovery gastrointestinal dysfunction by influencing the expression of gastrointestinal hormone. METHOD: The present study refers to a randomized, evaluator blinded, controlled, multi-center clinical trial; it was designed complying with the Consolidated Standards of Reporting Trials (CONSORT 2010) as well as the Standard for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). The subjects will be taken from the inpatients having undergone laparoscopic surgery of Mianyang Affiliated Hospital of Chengdu University of traditional Chinese medicine, Mianyang Third Hospital and Mianyang Anzhou Hospital. Based on the random number yielded using SPSS 25.0 software, the qualified subjects will be randomly classified to the experimental group and the control group. Therapies will be performed 30 min once after operation, the experimental group will be treated with acupuncture, while the control group will receive intravenous injection of granisetron. The major outcome will be the time to first flatus, and the secondary outcomes will include the time to first defecation, abdominal pain, dosage of analgesia pump, abdominal distention, nausea, vomiting, gastrointestinal hormone, as well as mental state. The efficacy and safety of acupuncture will be also assessed following the principle of Good Clinical Practice (GCP). DISCUSS: A standardized and scientific clinical trial is conducted to assess the efficacy and safety of acupuncture for gastrointestinal dysfunction after laparoscopic cholecystectomy under general anesthesia. The aim is to objectively evidence and improves the clinical practice of acupoint prescription, as an attempt to promote the clinical application of this technology.


Assuntos
Terapia por Acupuntura/métodos , Anestesia Geral/efeitos adversos , Colecistectomia Laparoscópica/efeitos adversos , Gastroenteropatias/terapia , Hormônios Gastrointestinais/sangue , Complicações Pós-Operatórias/terapia , Adolescente , Adulto , Idoso , Estudos de Viabilidade , Feminino , Gastroenteropatias/sangue , Gastroenteropatias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
2.
Nutrients ; 12(4)2020 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32268554

RESUMO

Protein-rich supplements are used commonly to increase energy intake in undernourished older people. This study aimed to establish age effects on energy intake, appetite, gastric emptying, blood glucose, and gut hormones in response to protein-rich drinks. In a randomized double-blind, order, 13 older men (age: 75 ± 2 yrs, body mass index (BMI): 26 ± 1 kg/m2) and 13 younger (23 ± 1 yrs, 24 ± 1 kg/m2) men consumed (i) a control drink (~2 kcal) or drinks (450 mL) containing protein/fat/carbohydrate: (ii) 70 g/0 g/0 g (280 kcal/'P280'), (iii) 14 g/12.4 g/28 g (280 kcal/'M280'), (iv) 70 g/12.4 g/28 g (504 kcal/'M504'), on four separate days. Appetite (visual analog scales), gastric emptying (3D ultrasonography), blood glucose, plasma insulin, ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1) concentrations (0-180 min), and ad-libitum energy intake (180-210 min) were determined. Older men, compared to younger men, had higher fasting glucose and CCK concentrations and lower fasting GLP-1 concentrations (all p < 0.05). Energy intake by P280 compared to control was less suppressed in older men (increase: 49 ± 42 kcal) than it was in younger men (suppression: 100 ± 54 kcal, p = 0.038). After the caloric drinks, the suppression of hunger and the desire to eat, and the stimulation of fullness was less (p < 0.05), and the stimulation of plasma GLP-1 was higher (p < 0.05) in older men compared to younger men. Gastric emptying, glucose, insulin, ghrelin, and CCK responses were similar between age groups. In conclusion, ageing reduces the responses of caloric drinks on hunger, the desire to eat, fullness, and energy intake, and protein-rich nutrition supplements may be an effective strategy to increase energy intake in undernourished older people.


Assuntos
Apetite/efeitos dos fármacos , Bebidas , Glicemia/metabolismo , Ingestão de Energia/efeitos dos fármacos , Esvaziamento Gástrico/efeitos dos fármacos , Hormônios Gastrointestinais/sangue , Proteínas do Soro do Leite/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino
3.
Nutrients ; 12(2)2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32023931

RESUMO

Cooking changes the texture and tenderness of red meat, which may influence its digestibility, circulatory amino acids (AA) and gastrointestinal (GI) hormonal responses in consumers. In a randomised crossover intervention, healthy males (n = 12) consumed a beef steak sandwich, in which the beef was cooked by either a pan-fried (PF) or sous-vide (SV) method. Plasma AA were measured by ultrahigh performance liquid chromatography (UPLC), while plasma GI hormones were measured using a flow cytometric multiplex array. Following meat ingestion, the circulatory concentrations of some of the essential AA (all the branched-chain AA: leucine, isoleucine and valine; and threonine), some of the nonessential AA (glycine, alanine, tyrosine and proline) and some of the nonproteogenic AA (taurine, citrulline and ornithine) were increased from fasting levels by 120 or 180 min (p < 0.05). There were no differences in circulating AA concentrations between cooking methods. Likewise, of the measured GI hormones, glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide-1 (GLP-1) concentrations increased from fasting levels after consumption of the steak sandwich (p < 0.05), with no differences between the cooking methods. In the healthy male adults, protein digestion and circulating GI hormone responses to a beef-steak breakfast were unaltered by the different cooking methods.


Assuntos
Aminoácidos/sangue , Culinária/métodos , Proteínas na Dieta/sangue , Hormônios Gastrointestinais/sangue , Carne Vermelha , Adolescente , Adulto , Estudos Cross-Over , Ingestão de Alimentos , Jejum/sangue , Voluntários Saudáveis , Humanos , Masculino , Período Pós-Prandial , Adulto Jovem
4.
Am J Clin Nutr ; 111(1): 28-41, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31742316

RESUMO

BACKGROUND: Altered meal-related gut hormone secretion seems important for weight loss and diabetes remission after Roux-en-Y gastric bypass (RYGB). Elucidating the responsible meal components and receptors could aid discovery of new treatments of obesity and diabetes. Enteroendocrine cells respond to digestion products of dietary triacylglycerol, especially long-chain fatty acids (LCFAs) and 2-oleoyl-glycerol (2-OG), but not medium-chain fatty acids (MCFAs). OBJECTIVE: We examined the impact of olive oil (20 mL) and its derivates, LCFAs and 2-OG, on enteroendocrine secretions [glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), cholecystokinin (CCK), peptide YY (PYY), and neurotensin (NT)] and on glucose, lipid, and bile acid metabolism in RYGB-operated and unoperated individuals. METHODS: In an exploratory randomized crossover design, 10 RYGB-operated patients and 10 matched controls ingested 3 equimolar triacylglycerol formulations on separate days: olive oil (digested to 2-OG + LCFAs), C8-dietary oil (2-OG + MCFAs), and tricaprylin (MCFAs; negative control). Hormone responses were calculated as area under the curve (AUC). RESULTS: Independent of group status, olive oil had greater effects than C8-dietary oil on AUCs of plasma GLP-1 (+32%; 95% CI: 23%, 43%; P < 0.01), CCK (+53%, P < 0.01), and NT (+71%, P < 0.01), whereas the effect on GIP differed between groups (+90% in controls, P < 0.01; +24% in RYGB, P = 0.10). Independent of group status, C8-dietary oil had greater effects than tricaprylin on AUCs of plasma CCK (+40%, P < 0.01) and NT (+32%, P < 0.01), but not GLP-1 (+5%; 95% CI: -2.9%, 13%; P = 0.22), whereas the effect on GIP again differed between groups (+78% in controls, P < 0.01; +39% in RYGB, P = 0.01). Distal (GLP-1/PYY/NT), but not proximal (CCK/GIP), enteroendocrine responses were generally greater in RYGB patients than in controls. CONCLUSIONS: The combination of LCFAs plus 2-OG was substantially more effective than 2-OG plus MCFAs in stimulating enteroendocrine secretion in RYGB-operated and matched control individuals. Distal lipid-induced gut hormone release was greater after RYGB.This trial was registered at clinicaltrials.gov as NCT03223389.


Assuntos
Gorduras na Dieta/metabolismo , Mucosa Intestinal/metabolismo , Obesidade/cirurgia , Adulto , Colecistocinina/sangue , Feminino , Derivação Gástrica , Polipeptídeo Inibidor Gástrico/sangue , Hormônios Gastrointestinais/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Glicerídeos/metabolismo , Humanos , Masculino , Obesidade/sangue , Obesidade/metabolismo , Peptídeo YY/sangue , Triglicerídeos/metabolismo
5.
Am J Clin Nutr ; 111(1): 131-140, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31557279

RESUMO

BACKGROUND: Crohn's disease (CD) patients suffer postprandial aversive symptoms, which can lead to anorexia and malnutrition. Changes in the regulation of gut hormones and gut dysmotility are believed to play a role. OBJECTIVES: This study aimed to investigate small-bowel motility and gut peptide responses to a standard test meal in CD by using MRI. METHODS: We studied 15 CD patients with active disease (age 36 ± 3 y; BMI 26 ± 1 kg/m 2) and 20 healthy volunteers (HVs; age 31 ± 3 years; BMI 24 ± 1 kg/m 2). They underwent baseline and postprandial MRI scans, symptom questionnaires, and blood sampling following a 400-g soup meal (204 kcal). Small-bowel motility, other MRI parameters, and glucagon-like peptide-1 (GLP-1), polypeptide YY (PYY), and cholecystokinin peptides were measured. Data are presented as means ± SEMs. RESULTS: HVs had significantly higher fasting motility indexes [106 ± 13 arbitrary units (a.u.)], compared with CD participants (70 ± 8 a.u.; P ≤ 0.05). Postprandial small-bowel water content showed a significant time by group interaction (P < 0.05), with CD participants showing higher levels from 210 min postprandially. Fasting concentrations of GLP-1 and PYY were significantly greater in CD participants, compared with HVs [GLP-1, CD 50 ± 8 µg/mL versus HV 13 ± 3 µg/mL (P ≤ 0.0001); PYY, CD 236 ± 16 pg/mL versus HV 118 ± 12 pg/mL (P ≤ 0.0001)]. The meal challenge induced a significant postprandial increase in aversive symptom scores (fullness, distention, bloating, abdominal pain, and sickness) in CD participants compared with HVs (P ≤ 0.05). CONCLUSIONS: The decrease in fasting small-bowel motility noted in CD participants can be ascribed to the increased fasting gut peptides. A better understanding of the etiology of aversive symptoms in CD will facilitate identification of better therapeutic targets to improve nutritional status. This trial was registered at clinicaltrials.gov as NCT03052465.


Assuntos
Doença de Crohn/metabolismo , Doença de Crohn/fisiopatologia , Hormônios Gastrointestinais/sangue , Intestino Delgado/fisiopatologia , Adulto , Idoso , Colecistocinina/sangue , Doença de Crohn/diagnóstico por imagem , Jejum/metabolismo , Feminino , Motilidade Gastrointestinal , Peptídeo 1 Semelhante ao Glucagon/sangue , Humanos , Intestino Delgado/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Peptídeo YY/sangue , Período Pós-Prandial , Adulto Jovem
6.
Metabolism ; 101: 153997, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31672446

RESUMO

AIMS: Bariatric surgery leads to profound and sustainable weight loss. Gastrointestinal hormones are involved in energy and glucose homeostasis, thus postoperative changes of their circulating levels may be mediating future weight loss. To investigate how the circulating concentrations of gastrointestinal hormones change in response to the most common types of bariatric operation and whether these changes can predict future weight loss. MATERIALS AND METHODS: We measured circulating GLP-1, GLP-2, oxyntomodulin, glicentin, glucagon, major proglucagon fragment (MPGF), ghrelin, GIP, PYY after overnight fasting and/or after a mixed meal test (MMT) in: a) 14 subjects that have undergone either an adjustable gastric banding [AGB] (n = 9) or a Roux-en-Y bypass (RYGB) (n = 5) (Pilot study 1), b) 28 subjects that have undergone either a vertical sleeve gastrectomy (n = 17) or a RYGB (n = 11) before and three, six and twelve months after surgery. RESULTS: In addition to the expected associations with GLP-1, the most robust increases were observed in postprandial levels of oxyntomodulin and glicentin three months after VSG or RYGB (but not after AGB) and are associated with degree of weight loss. Oxyntomodulin and glicentin levels at the third and sixth month postoperative visit are positively associated with feeling of satiety which may be underlying the observed associations with future weight loss. CONCLUSION: Beyond GLP-1, early postprandial changes in circulating oxyntomodulin and glicentin are predictors of weight loss after bariatric surgery, possibly through regulation of satiety. Further studies should focus on underlying mechanisms, and their potential as attractive therapeutic tools against obesity and related comorbidities.


Assuntos
Cirurgia Bariátrica/métodos , Hormônios Gastrointestinais/sangue , Perda de Peso , Adulto , Feminino , Glicentina/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Oxintomodulina/sangue , Período Pós-Prandial , Valor Preditivo dos Testes , Prognóstico
7.
J BUON ; 24(4): 1595-1600, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31646814

RESUMO

PURPOSE: To investigate the correlations of gastrointestinal hormones with inflammation and intestinal flora in patients with gastric cancer. METHODS: The data of patients with gastric cancer in the Department of Oncology and people with normal physical examination in our hospital were included. All patients received FOLFOX4 chemotherapy. The expression levels of gastrointestinal hormones and inflammatory cytokines were compared between the two groups, and the changes in the intestinal flora spectrum were analyzed. Two-sample t-test was used for the comparison between groups. Pearson's test was used for correlation analysis. P<0.05 showed statistical significance. RESULTS: The levels of serum gastrin-17 (G17) and pepsinogen II (PG II) detected in gastric cancer patients were higher than those in the control group, and the higher the tumor stage, the higher the expression levels. After therapy with PG I, the G17 and PG II levels increased. Moreover, the levels of serum interleukin-6 (IL-6) and IL-17 in patients with gastric cancer were higher than those in normal controls, and the higher the tumor stage, the higher the expression levels. After therapy with IL-6, the IL-6 and IL-7 levels were reduced. In addition, in gastric cancer patients, the numbers of Bifidobacteria, Lactobacilli and bacilli or cocci were apparently decreased, and were markedly increased after therapy, while those of Escherichia coli, Staphylococci, Enterococci and Peptostreptococci were significantly increased, and were evidently decreased after therapy. The results revealed that G17 had positive correlations with IL-6 and IL-17, PG II was positively correlated with IL-17, and G17 was negatively related to the numbers of Bifidobacteria and Lactobacilli. CONCLUSIONS: Gastrointestinal hormones are involved in the occurrence and development of gastric cancer, and they have certain correlations with the inflammation and intestinal flora leading to the tumor genesis.


Assuntos
Carcinogênese/genética , Hormônios Gastrointestinais/sangue , Inflamação/tratamento farmacológico , Neoplasias Gástricas/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Escherichia coli/efeitos dos fármacos , Escherichia coli/patogenicidade , Feminino , Fluoruracila/administração & dosagem , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrinas/sangue , Microbioma Gastrointestinal/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/patogenicidade , Humanos , Inflamação/sangue , Inflamação/microbiologia , Inflamação/patologia , Interleucina-17/sangue , Interleucina-6/sangue , Leucovorina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Compostos Organoplatínicos/administração & dosagem , Pepsinogênio C/sangue , Neoplasias Gástricas/sangue , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia
8.
Obesity (Silver Spring) ; 27(10): 1627-1633, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31411376

RESUMO

OBJECTIVE: This study portrays the effect of hedonic manipulation (high acceptability [HA] vs. low acceptability [LA]) on postprandial hormones and appetite scores in healthy males. METHODS: Thirty participants (15 with normal weight and 15 with obesity) were recruited for a randomized, crossover design. They were randomly assigned to the HA or LA (with acesulfame-K) custard. Blood samples were drawn before the meals and for 4 hours after the meals and were analyzed for glucose, insulin, ghrelin, and glucagonlike peptide 1 (GLP-1). Appetite scores and subsequent energy intake were recorded. RESULTS: Postprandial glucose, insulin, and ghrelin were different according to adiposity, whereas meal acceptability did not correspond to any significant difference in postprandial glucose, insulin, ghrelin, and GLP-1 concentrations. Appetite scores showed lower hunger, higher satiety, and fullness after the HA meal without a significant difference between the meals. Subsequent energy intake, expressed as a percentage of the resting energy expenditure, was higher in participants with obesity but did not reflect postprandial hormones and appetite scores; there was no significant difference between meals. CONCLUSIONS: Hedonic properties and palatability do not affect gut hormones, mainly ghrelin and GLP-1. Moreover, their postprandial concentrations were not paralleled by similar changes in appetite scores, and both were not found to affect subsequent intake.


Assuntos
Adiposidade/fisiologia , Apetite/fisiologia , Hormônios Gastrointestinais/sangue , Refeições/psicologia , Satisfação Pessoal , Saciação/fisiologia , Adolescente , Adulto , Estudos Cross-Over , Método Duplo-Cego , Ingestão de Energia/fisiologia , Grelina/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Humanos , Fome/fisiologia , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/metabolismo , Obesidade/fisiopatologia , Período Pós-Prandial/fisiologia , Projetos de Pesquisa , Adulto Jovem
9.
Bull Exp Biol Med ; 167(3): 325-328, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31346871

RESUMO

We studied the relationships between body composition parameters and plasma levels of pancreatic, gut, and adipose tissue hormones regulating energy balance and glucose metabolism in diabetic db/db mice (BKS.Cg-Dock7m+/+Leprdb/J). The body composition parameters in mice aged 8, 12, and 16 weeks were assessed by magnetic resonance imaging. The concentrations of insulin, glucagon, ghrelin, glucagon-like peptide-1, glucose-dependent immunotropic peptide, leptin, resistin, and plasminogen activator-1 were measured by multiplex analysis at the age of 8 and 16 weeks. In comparison with non-diabetic control (db/+), db/db mice demonstrated high fat mass and reduced lean body mass and water content. In 8- and 16-week-old db/db mice, the levels of leptin (p<0.001), insulin (p<0.01), and glucagon-like peptide-1 (p<0.05) were elevated and the concentration of ghrelin (p<0.05) was reduced. The body weight and fat mass positively correlated with the levels of leptin, insulin, plasminogen activator-1, and glucagon-like peptide-1 and negatively correlated with ghrelin concentration. The results provide further details for characteristics of db/db mice, a widely used model of obesity and type 2 diabetes mellitus.


Assuntos
Tecido Adiposo/metabolismo , Composição Corporal/fisiologia , Diabetes Mellitus Tipo 2/sangue , Hormônios Gastrointestinais/sangue , Hormônios Pancreáticos/sangue , Animais , Grelina/sangue , Glucagon/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Glucose/metabolismo , Insulina/sangue , Leptina/sangue , Masculino , Camundongos , Camundongos Endogâmicos NOD , Ativadores de Plasminogênio/sangue , Resistina/sangue
10.
Am J Clin Nutr ; 109(5): 1335-1343, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31051504

RESUMO

BACKGROUND: The fatty acid, lauric acid ('C12'), and the amino acid, L-tryptophan ('Trp'), modulate gastrointestinal functions including gut hormones and pyloric pressures, which are important for the regulation of energy intake, and both potently suppress energy intake. OBJECTIVE: We hypothesized that the intraduodenal administration of C12 and Trp, at loads that do not affect energy intake individually, when combined will reduce energy intake, which is associated with greater modulation of gut hormones and pyloric pressures. DESIGN: Sixteen healthy, lean males (age: 24 ± 1.5 y) received 90-min intraduodenal infusions of saline (control), C12 (0.3 kcal/min), Trp (0.1 kcal/min), or C12 + Trp (0.4 kcal/min), in a randomized, double-blind, cross-over study. Antropyloroduodenal pressures were measured continuously, and plasma cholecystokinin (CCK), ghrelin, and glucagon-like peptide-1 (GLP-1) concentrations, appetite perceptions, and gastrointestinal symptoms at 15-min intervals. Immediately after the infusions, energy intake from a standardized buffet meal was quantified. RESULTS: C12 + Trp markedly reduced energy intake (kcal; control: 1,232 ± 72, C12: 1,180 ± 82, Trp: 1,269 ± 73, C12 + Trp: 1,056 ± 106), stimulated plasma CCK (AUC(area under the curve)0-90 min, pmol/L*min; control: 21 ± 8; C12: 129 ± 15; Trp: 97 ± 16; C12 + Trp: 229 ± 22) and GLP-1 (AUC0-90 min, pmol/L*min; control: 102 ± 41; C12: 522 ± 102; Trp: 198 ± 63; C12 + Trp: 545 ± 138), and suppressed ghrelin (AUC0-90 min, pg/mL*min; control: -3,433 ± 2,647; C12: -11,825 ± 3,521; Trp: -8,417 ± 3,734; C12 + Trp: -18,188 ± 4,165) concentrations, but did not stimulate tonic, or phasic, pyloric pressures, compared with the control (all P < 0.05), or have adverse effects. C12 and Trp each stimulated CCK (P < 0.05), but to a lesser degree than C12 + Trp, and did not suppress energy intake or ghrelin. C12, but not Trp, stimulated GLP-1 (P < 0.05) and phasic pyloric pressures (P < 0.05), compared with the control. CONCLUSION: The combined intraduodenal administration of C12 and Trp, at loads that individually do not affect energy intake, substantially reduces energy intake, which is associated with a marked stimulation of CCK and suppression of ghrelin. The study was registered as a clinical trial at the Australian and New Zealand Clinical Trial Registry (www.anzctr.org.au,) as 12613000899741.


Assuntos
Colecistocinina/sangue , Ingestão de Energia/efeitos dos fármacos , Grelina/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Ácidos Láuricos/farmacologia , Piloro/efeitos dos fármacos , Triptofano/farmacologia , Adulto , Apetite , Estudos Cross-Over , Método Duplo-Cego , Duodeno , Ingestão de Alimentos/efeitos dos fármacos , Ingestão de Alimentos/fisiologia , Ingestão de Energia/fisiologia , Hormônios Gastrointestinais/sangue , Humanos , Ácidos Láuricos/administração & dosagem , Masculino , Pressão , Valores de Referência , Triptofano/administração & dosagem , Adulto Jovem
11.
Nutr Rev ; 77(7): 455-477, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31125091

RESUMO

Several types of hormones exert control over appetite in humans. This narrative review explores the effects of exercise and training on the concentrations of gastrointestinal hormones in healthy and obese individuals. It focuses on the major hormones of appetite regulation: ghrelin, glucagon-like peptide 1, peptide YY, cholecystokinin, leptin, and oxyntomodulin. In normal-weight and overweight individuals, responses to most of these hormones depend on the intensity of exercise and training. However, findings in obese individuals are limited in number and, to some degree, contradictory. Although some gastrointestinal hormones have been studied extensively (eg, leptin), most have not been investigated systematically. Further research is required to confirm the effectiveness of exercise and training on gut hormones and to better understand the effect of gut hormones on appetite and hunger suppression in individuals with obesity. Investigations to elucidate the impact of various forms of exercise that have recently engaged the public interest, eg, high-intensity interval training or concurrent aerobic and resistance training, are warranted.


Assuntos
Apetite/fisiologia , Peso Corporal/fisiologia , Exercício Físico/fisiologia , Hormônios Gastrointestinais/sangue , Obesidade/fisiopatologia , Humanos , Fome/fisiologia , Obesidade/sangue
12.
Curr Obes Rep ; 8(2): 77-87, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31037612

RESUMO

PURPOSE OF REVIEW: The goals of this paper are to report current research practices in investigations of human appetite control and to assess their relationships with emerging theoretical principles. Appetite is often distinguished by the separation of homeostatic and hedonic processes. RECENT FINDINGS: This report assesses the validity of a homeostatic toolkit to measure subjectively perceived hunger and its relationship to the developing processes of satiation (control of meal size) and satiety (control of the post-eating period). The capacity of a procedure to measure the influence of hedonic processes on food intake is also evaluated. A major issue is the relationship between the pattern of eating behaviour (influenced by the underlying drive to eat and the inhibition induced by the act of eating itself) and the parallel underlying profile of hormonal and other metabolic biomarkers. Increasing recognition is being given to individual variability in the expression of appetite, and the fact that the use of the average (mean) response conceals important information about the nature of appetite control. There is a growing interest in the identification of satiety phenotypes that operate in parallel to metabolic phenotypes. Interestingly, energy expenditure (metabolic and behavioural) contributes to an energy balance framework for understanding energy intake (appetite).


Assuntos
Apetite , Obesidade/epidemiologia , Saciação , Regulação do Apetite , Biomarcadores/sangue , Composição Corporal , Ingestão de Alimentos/psicologia , Metabolismo Energético , Hormônios Gastrointestinais/sangue , Comportamentos Relacionados com a Saúde , Humanos , Fome , Refeições , Obesidade/psicologia , Hormônios Peptídicos/sangue , Tamanho da Porção
13.
Am J Clin Nutr ; 109(4): 1051-1063, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30949710

RESUMO

BACKGROUND: The endocannabinoid system (ECS) is considered a key player in the neurophysiology of food reward. Animal studies suggest that the ECS stimulates the sensory perception of food, thereby increasing its incentive-motivational and/or hedonic properties and driving consumption, possibly via interactions with metabolic hormones. However, it remains unclear to what extent this can be extrapolated to humans. OBJECTIVE: We aimed to investigate the effect of oral Δ9-tetrahydrocannabinol (THC) on subjective and metabolic hormone responses to visual food stimuli and food intake. METHODS: Seventeen healthy subjects participated in a single-blinded, placebo-controlled, 2 × 2 crossover trial. In each of the 4 visits, subjective "liking" and "wanting" ratings of high- and low-calorie food images were acquired after oral THC or placebo administration. The effect on food intake was quantified in 2 ways: via ad libitum oral intake (half of the visits) and intragastric infusion (other half) of chocolate milkshake. Appetite-related sensations and metabolic hormones were measured at set time points throughout each visit. RESULTS: THC increased "liking" (P = 0.031) and "wanting" ratings (P = 0.0096) of the high-calorie, but not the low-calorie images, compared with placebo. Participants consumed significantly more milkshake after THC than after placebo during oral intake (P = 0.0005), but not intragastric infusion, of milkshake. Prospective food consumption ratings during the food image paradigm were higher after THC than after placebo (P = 0.0039). THC also increased plasma motilin (P = 0.0021) and decreased octanoylated ghrelin (P = 0.023) concentrations before milkshake consumption (i.e., in both oral intake and intragastric infusion test sessions), whereas glucagon-like peptide 1 responses to milkshake intake were attenuated by THC during both oral (P = 0.0002) and intragastric (P = 0.0055) administration. CONCLUSIONS: These findings suggest that the ECS drives food intake by interfering with anticipatory, cephalic phase, and metabolic hormone responses. This trial was registered at clinicaltrials.gov as NCT02310347.


Assuntos
Dronabinol/administração & dosagem , Ingestão de Alimentos/efeitos dos fármacos , Hormônios Gastrointestinais/sangue , Grelina/sangue , Adulto , Apetite/efeitos dos fármacos , Feminino , Peptídeo 1 Semelhante ao Glucagon/sangue , Voluntários Saudáveis , Humanos , Masculino , Motilina/sangue , Adulto Jovem
14.
Endocr J ; 66(5): 395-401, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31019154

RESUMO

Elevation of postprandial plasma glucose is correlated with an increase in cardiovascular events, and alpha-glucosidase inhibitors (αGIs) are effective at reducing postprandial glucose levels. In Japan, the αGIs acarbose, voglibose, and miglitol have been available since 1993, 1994, and 2006, respectively. Dipeptidyl peptidase-4 (DPP-4) inhibitors are also effective at reducing postprandial glucose levels, and they have been available in Japan since 2009. A combination therapy of αGI, miglitol, and the DPP-4 inhibitor, sitagliptin, is more effective at decreasing postprandial glucose levels than monotherapy with either miglitol or sitagliptin. Moreover, the combination therapy of miglitol and sitagliptin is more effective at increasing postprandial active glucagon-like peptide-1 (GLP-1) levels than monotherapy. Peptide YY (PYY) has appetite-suppressing and gastric-emptying effects similar to GLP-1. In healthy individuals, miglitol increases the postprandial total PYY; however, combination therapy of miglitol and vildagliptin does not change postprandial total PYY levels. αGIs are typically prescribed to be taken just before a meal, which can result in decreased drug adherence. Different patterns of αGI intake were examined, and the results showed that miglitol or acarbose administration after a meal is effective. The effects of taking miglitol dissolved in water during a meal appeared to be similar to that of taking miglitol as a tablet just before a meal. The long-term effects of taking miglitol dissolved in water should be evaluated in future studies. αGIs may be effective even when they are not taken before a meal, and a more flexible administration may improve drug adherence.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Hormônios Gastrointestinais/sangue , Inibidores de Glicosídeo Hidrolases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Glicemia , Diabetes Mellitus/sangue , Inibidores de Glicosídeo Hidrolases/administração & dosagem , Humanos , Hipoglicemiantes/administração & dosagem , Resultado do Tratamento
15.
Obes Surg ; 29(7): 2092-2099, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30976983

RESUMO

BACKGROUND: Hypoglycemia is an increasingly recognized complication of bariatric surgery. Mechanisms contributing to glucose lowering remain incompletely understood. We aimed to identify differentially abundant plasma proteins in patients with post-bariatric hypoglycemia (PBH) after Roux-en-Y gastric bypass (RYGB), compared to asymptomatic post-RYGB. METHODS: Proteomic analysis of blood samples collected after overnight fast and mixed meal challenge in individuals with PBH, asymptomatic RYGB, severe obesity, or overweight recruited from outpatient hypoglycemia or bariatric clinics. RESULTS: The top-ranking differentially abundant protein at 120 min after mixed meal was fibroblast growth factor 19 (FGF-19), an intestinally derived hormone regulated by bile acid-FXR signaling; levels were 2.4-fold higher in PBH vs. asymptomatic post-RYGB (mean + SEM, 1094 ± 141 vs. 428 ± 45, P < 0.001, FDR < 0.01). FGF-19 ELISA confirmed 3.5-fold higher concentrations in PBH versus asymptomatic (360 ± 70 vs. 103 ± 18, P = 0.025). To explore potential links between increased FGF-19 and GLP-1, residual samples from other human studies in which GLP-1 was modulated were assayed. FGF-19 levels did not change in response to infusion of GLP-1 and PYY in overweight/obese individuals. Infusion of the GLP-1 receptor antagonist exendin 9-39 in recently operated asymptomatic post-RYGB did not alter FGF-19 levels after mixed meal. By contrast, GLP-1 receptor antagonist infusion yielded a significant increase in FGF-19 levels after oral glucose in individuals with PBH. While plasma bile acids did not differ between PBH and asymptomatic post-RYGB, these data suggest unique interrelationships between GLP-1 and FGF-19 in PBH. CONCLUSIONS: Taken together, these data support FGF-19 as a potential contributor to insulin-independent pathways driving postprandial hypoglycemia in PBH.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Fatores de Crescimento de Fibroblastos/sangue , Hipoglicemia/sangue , Hipoglicemia/etiologia , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/sangue , Adulto , Glicemia/metabolismo , Proteínas Sanguíneas/análise , Proteínas Sanguíneas/metabolismo , Estudos de Casos e Controles , Feminino , Derivação Gástrica/efeitos adversos , Hormônios Gastrointestinais/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Receptor do Peptídeo Semelhante ao Glucagon 1/antagonistas & inibidores , Humanos , Hipoglicemia/dietoterapia , Hipoglicemia/tratamento farmacológico , Masculino , Refeições , Pessoa de Meia-Idade , Obesidade Mórbida/sangue , Fragmentos de Peptídeos/uso terapêutico , Complicações Pós-Operatórias/dietoterapia , Complicações Pós-Operatórias/tratamento farmacológico , Proteoma/análise , Proteômica , Regulação para Cima
16.
Br J Surg ; 106(6): 735-746, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30883706

RESUMO

BACKGROUND: Oesophagectomy is associated with reduced appetite, weight loss and postprandial hypoglycaemia, the pathophysiological basis of which remains largely unexplored. This study aimed to investigate changes in enteroendocrine function after oesophagectomy. METHODS: In this prospective study, 12 consecutive patients undergoing oesophagectomy were studied before and 10 days, 6, 12 and 52 weeks after surgery. Serial plasma total fasting ghrelin, and glucagon-like peptide 1 (GLP-1), insulin and glucose release following a standard 400-kcal mixed-meal stimulus were determined. CT body composition and anthropometry were assessed, and symptom scores calculated using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires. RESULTS: At 1 year, two of the 12 patients exhibited postprandial hypoglycaemia, with reductions in bodyweight (mean(s.e.m.) 17·1(3·2) per cent, P < 0·001), fat mass (21.5(2.5) kg versus 25.5(2.4) kg before surgery; P = 0·014), lean body mass (51.5(2.2) versus 54.0(1.8) kg respectively; P = 0·003) and insulin resistance (HOMA-IR: 0.84(0.17) versus 1.16(0.20); P = 0·022). Mean(s.e.m.) fasting ghrelin levels decreased from postoperative day 10, but had recovered by 1 year (preoperative: 621·5(71·7) pg/ml; 10 days: 415·1(59·80) pg/ml; 6 weeks: 309·0(42·0) pg/ml; 12 weeks: 415·8(52·1) pg/ml; 52 weeks: 547·4(83·2) pg/ml; P < 0·001) and did not predict weight loss (P = 0·198). Postprandial insulin increased progressively at 10 days, 6, 12 and 52 weeks (mean(s.e.m.) insulin AUC0-30 min : fold change 1·7(0·4), 2·0(0·4), 3·5(0·7) and 4·0(0·8) respectively; P = 0·001). Postprandial GLP-1 concentration increased from day 10 after surgery (P < 0·001), with a 3·3(1·8)-fold increase at 1 year (P < 0·001). Peak GLP-1 level was inversely associated with the postprandial glucose nadir (P = 0·041) and symptomatic neuroglycopenia (Sigstad score, P = 0·017, R2 = 0·45). GLP-1 AUC predicted loss of weight (P = 0·008, R2 = 0·52) and fat mass (P = 0·010, R2 = 0·64) at 1 year. CONCLUSION: Altered enteroendocrine physiology is associated with early satiety, weight loss and postprandial hypoglycaemia after oesophagectomy.


Assuntos
Esofagectomia , Hormônios Gastrointestinais/sangue , Hipoglicemia/etiologia , Complicações Pós-Operatórias/etiologia , Adulto , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Composição Corporal , Feminino , Seguimentos , Grelina/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Humanos , Hipoglicemia/sangue , Hipoglicemia/diagnóstico , Hipoglicemia/fisiopatologia , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Período Pós-Prandial , Estudos Prospectivos , Resposta de Saciedade , Perda de Peso
17.
Gastroenterology ; 156(6): 1627-1641.e1, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30742833

RESUMO

BACKGROUND & AIMS: Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) induce substantial weight loss and improve glycemic control in patients with type 2 diabetes, but it is not clear whether these occur via the same mechanisms. We compared absorption rates of glucose and protein, as well as profiles of gastro-entero-pancreatic hormones, in patients who had undergone SG or RYGB vs controls. METHODS: We performed a cross-sectional study of 12 patients who had undergone sleeve gastrectomy, 12 patients who had undergone RYGB, and 12 individuals who had undergone neither surgery (controls), all in Denmark. Study participants were matched for body mass index, age, sex, and postoperative weight loss, and all had stable weights. They received continuous infusions of stable isotopes of glucose, glycerol, phenylalanine, tyrosine, and urea before and during a mixed meal containing labeled glucose and intrinsically phenylalanine-labeled caseinate. Blood samples were collected for 6 hours, at 10- to 60-minute intervals, and analyzed. RESULTS: The systemic appearance of ingested glucose was faster after RYGB and SG vs controls; the peak glucose appearance rate was 64% higher after RYGB, and 23% higher after SG (both P < .05); the peak phenylalanine appearance rate from ingested casein was 118% higher after RYGB (P < .01), but similar between patients who had undergone SG and controls. Larger, but more transient increases in levels of plasma glucose and amino acids were accompanied by higher secretion of insulin, glucagon-like peptide 1, peptide YY, and cholecystokinin after RYGB, whereas levels of ghrelin were lower after SG, compared with RYGB and controls. Total 6-hour oral recovery of ingested glucose and protein was comparable among groups. CONCLUSIONS: Postprandial glucose and protein absorption and gastro-entero-pancreatic hormone secretions differ after SG and RYGB. RYGB was characterized by accelerated absorption of glucose and amino acids, whereas protein metabolism after SG did not differ significantly from controls, suggesting that different mechanisms explain improved glycemic control and weight loss after these surgical procedures. ClinicalTrials.gov ID NCT03046186.


Assuntos
Gastrectomia/métodos , Derivação Gástrica/métodos , Hormônios Gastrointestinais/sangue , Glucose/metabolismo , Absorção Intestinal , Fenilalanina/metabolismo , Adulto , Anastomose em-Y de Roux , Glicemia/metabolismo , Caseínas/metabolismo , Colecistocinina/sangue , Estudos Transversais , Proteínas na Dieta/metabolismo , Feminino , Esvaziamento Gástrico , Grelina/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Glucose/farmacocinética , Glicerol/sangue , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Peptídeo YY/sangue , Fenilalanina/sangue , Fenilalanina/farmacocinética , Período Pós-Prandial/fisiologia
18.
Mol Nutr Food Res ; 63(7): e1800967, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30763457

RESUMO

INTRODUCTION: The effect of whole-grain (WG) versus refined-grain (RG) diets on glucose-stimulated insulin secretion (GSIS) and ß-cell function is unclear. METHODS: In a double-blind crossover randomized controlled trial, 13 prediabetic adults (37.2 ± 1.8 y, BMI: 33.6 ± 1.4 kg m-2 , 2 h glucose: 146.9 ± 11.6 mg dL-1 ) are provided isocaloric-matched WG and RG diets for 8-weeks each, with an 8-10 week washout between diets. Glucose, insulin, and C-peptide are studied over 240 min following a 75 g OGTT. Incretins (GLP-1 and GIP), PYY, and total ghrelin are assessed at 0, 30, and 60 min. Mixed-meal diets for carbohydrate (54%), fat (28%), and protein (18%) contain either WG (50 g/1000 kcal) or equivalent RG. RESULTS: Both diets induce fat loss (≈2 kg). While neither diet impacts early phase GSIS, the WG diet increases total GSIS (iAUC of C-peptide0-240 /Glc0-240 , p = 0.02) and ß-cell function (disposition index; GSIS × insulin sensitivity, p = 0.02). GIP and PYY are unaltered by either diet, but GLP-1 is higher at 30 min following RG versus WG (p = 0.04). Ghrelin levels are higher at 60 min of the OGTT following both interventions (p = 0.01). CONCLUSION: A WG-rich diet increases ß-cell function independent of gut hormones in adults with prediabetes.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Hormônios Gastrointestinais/sangue , Secreção de Insulina , Estado Pré-Diabético/dietoterapia , Grãos Integrais , Adulto , Peptídeo C/sangue , Dieta , Método Duplo-Cego , Feminino , Glucose/metabolismo , Humanos , Incretinas/sangue , Insulina/sangue , Masculino , Estado Pré-Diabético/metabolismo
19.
Reproduction ; 157(5): 431-443, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30790767

RESUMO

Pregnancy and lactation increase maternal appetite and adiposity, which in humans can lead to long-term body mass retention. Previous rat reproduction studies suggest that appetite-inhibiting gut hormone, peptide-YY (PYY), is elevated, despite hyperphagia also that gastrointestinal size increases. The present study characterised changes in orexigenic (appetite-stimulating) ghrelin and anorexigenic (appetite-inhibiting) PYY and glucagon-like peptide-1 (GLP-1), and gastrointestinal architecture during pregnancy and lactation, in matched fed and fasted plasma and gut tissue samples taken during the dark phase. Enteroendocrine cells were immunolabelled, and gut masses and lengths were measured. Fasted plasma ghrelin reduced during pregnancy: it was lowest by day 18, recovered to control values at parturition, then increased by the end of lactation. Ghrelin-immunoreactive stomach cells and stomach ghrelin concentrations were highest at birth, prior to the onset of lactation-associated hyperphagia. Plasma fed GLP-1 concentrations were elevated during pregnancy, and together with higher colon concentrations of PYY and GLP-1 during early lactation, they were associated with gastrointestinal tissue expansion, not satiety. Body mass increased during lactation, whereas white adipose tissue depots depleted. Extensive gut remodelling coincided with elevated colon concentrations of PYY and GLP-1. Modifications included stomach and caecum expansion, and duodenal, ascending and descending colon circumference increases, all peaking by day 10 of lactation; increased intestinal masses and lengths peaking at lactation day 10 for small intestine and lactation day 25 for large intestine. If these physical tissue increases persist post-partum, they could accelerate future nutrient assimilation and storage in dams, and may contribute to increased obesity risk.


Assuntos
Adaptação Fisiológica/fisiologia , Apetite/fisiologia , Hormônios Gastrointestinais/metabolismo , Trato Gastrointestinal/fisiologia , Lactação/fisiologia , Gravidez/fisiologia , Animais , Aleitamento Materno , Ingestão de Alimentos/fisiologia , Feminino , Hormônios Gastrointestinais/sangue , Trato Gastrointestinal/crescimento & desenvolvimento , Ganho de Peso na Gestação/fisiologia , Tamanho do Órgão , Período Pós-Parto/sangue , Gravidez/sangue , Ratos , Ratos Wistar
20.
Nutrients ; 11(1)2019 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-30642053

RESUMO

Gastrointestinal hormones are involved in regulation of glucose metabolism and satiety. We tested the acute effect of meal composition on these hormones in three population groups. A randomized crossover design was used to examine the effects of two energy- and macronutrient-matched meals: a processed-meat and cheese (M-meal) and a vegan meal with tofu (V-meal) on gastrointestinal hormones, and satiety in men with type 2 diabetes (T2D, n = 20), obese men (O, n = 20), and healthy men (H, n = 20). Plasma concentrations of glucagon-like peptide -1 (GLP-1), amylin, and peptide YY (PYY) were determined at 0, 30, 60, 120 and 180 min. Visual analogue scale was used to assess satiety. We used repeated-measures Analysis of variance (ANOVA) for statistical analysis. Postprandial secretion of GLP-1 increased after the V-meal in T2D (by 30.5%; 95%CI 21.2 to 40.7%; p < 0.001) and H (by 15.8%; 95%CI 8.6 to 23.5%; p = 0.01). Postprandial plasma concentrations of amylin increased in in all groups after the V-meal: by 15.7% in T2D (95%CI 11.8 to 19.6%; p < 0.001); by 11.5% in O (95%CI 7.8 to 15.3%; p = 0.03); and by 13.8% in H (95%CI 8.4 to 19.5%; p < 0.001). An increase in postprandial values of PYY after the V-meal was significant only in H (by 18.9%; 95%CI 7.5 to 31.3%; p = 0.03). Satiety was greater in all participants after the V-meal: by 9% in T2D (95%CI 4.4 to 13.6%; p = 0.004); by 18.7% in O (95%CI 12.8 to 24.6%; p < 0.001); and by 25% in H (95%CI 18.2 to 31.7%; p < 0.001). Our results indicate there is an increase in gut hormones and satiety, following consumption of a single plant-based meal with tofu when compared with an energy- and macronutrient-matched processed-meat meat and cheese meal, in healthy, obese and diabetic men.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Dieta Vegetariana , Hormônios Gastrointestinais/sangue , Refeições , Obesidade/sangue , Saciação , Adulto , Idoso , Glicemia/metabolismo , Índice de Massa Corporal , Colesterol/sangue , Estudos Cross-Over , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Hemoglobina A Glicada/metabolismo , Humanos , Insulina/sangue , Masculino , Produtos da Carne , Pessoa de Meia-Idade , Período Pós-Prandial , Triglicerídeos/sangue
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