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Comparison of surgical versus diet‐induced weight loss on appetite regulation and metabolic health outcomes

机译：手术减肥与饮食减肥对食欲调节和代谢健康结果的比较

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Bariatric surgery is associated with significant and sustained weight loss and improved metabolic outcomes. It is unclear if weight loss alone is the main mechanism of improved metabolic health. The purpose of this trial was to compare indices of appetite regulation, insulin sensitivity and energy intake (EI) between participants achieving 10?kg of weight loss via Roux‐en‐Y Gastric Bypass (RYGB) or dietary restriction (DIET); intake of a very low calorie liquid diet (800?kcal/d; 40% protein, 40% fat, 20% carbohydrate that matched the post‐RYGB dietary protocol). Adults qualifying for bariatric surgery were studied before and after 10?kg of weight loss (RYGB [ n ?=?6]) or DIET [ n ?=?17]). Appetite (hunger, satiety, and prospective food consumption [PFC]), appetite–related hormones, and metabolites (ghrelin, PYY, GLP‐1, insulin, glucose, free fatty acids [FFA], and triglycerides [TG]) were measured in the fasting state and every 30?min for 180?min following breakfast. Participants were provided lunch to evaluate acute ad?libitum EI, which was similarly reduced in both groups from pre to post weight loss. Fasting ghrelin was reduced to a greater extent following RYGB compared to DIET ( P ?=?0.04). Area under the curve (AUC) for ghrelin ( P ?=?0.01), hunger ( P ??0.01) and PFC ( P ??0.01) increased after DIET compared to RYGB, following 10?kg weight loss. Satiety AUC increased after RYGB and decreased after DIET ( P ??0.01). Glucose and insulin (fasting and AUC) decreased in both groups. FFA increased in both groups, with a greater increase in AUC seen after RYGB versus DIET ( P ?=?0.02). In summary, appetite–related indices were altered in a manner that, if maintained, may promote a sustained reduction in energy intake with RYGB compared to DIET. Future work with a larger sample size and longer follow‐up will be important to confirm and extend these findings.
机译：减肥手术与持续的明显减肥和改善的代谢结果有关。目前尚不清楚减肥是否是改善代谢健康的主要机制。该试验的目的是比较通过Roux-en-Y胃旁路（RYGB）或饮食限制（DIET）实现体重减轻10公斤的参与者之间的食欲调节，胰岛素敏感性和能量摄入（EI）指标;摄入非常低卡路里的流质饮食（800kcal / d; 40％的蛋白质，40％的脂肪，20％的碳水化合物，符合RYGB后的饮食习惯）。在减肥10公斤（RYGB [n？=？6]）或DIET [n？=？17]之前和之后，对有资格进行减肥手术的成年人进行了研究。测量食欲（饥饿，饱腹感和预期食物消耗[PFC]），食欲相关激素和代谢物（生长素释放肽，PYY，GLP-1，胰岛素，葡萄糖，游离脂肪酸[FFA]和甘油三酸酯[TG]）在空腹状态下，早餐后每30分钟持续180分钟。为参与者提供午餐以评估急性随意性EI，两组在体重减轻之前和之后均类似减少。与DIET相比，RYGB后空腹生长激素释放肽的减少程度更大（P = 0.04）。与RYGB相比，DIET后生长激素释放肽（P <= 0.01），饥饿（P 0.01）和PFC（P 0.01），曲线下面积（AUC）在体重减轻10kg后有所增加。 RYGB后饱足AUC升高，而DIET后饱足AUC降低（P <0.01）。两组的葡萄糖和胰岛素（禁食和AUC）均降低。两组的FFA均增加，RYGB后的DIC与DIET相比，AUC显着增加（P = 0.02）。总之，食欲相关指标的改变方式如下：如果保持饮食状态，与DIET相比，RYGB可以持续减少能量摄入。未来需要进行更大样本量和更长随访时间的工作对于确认和扩展这些发现很重要。

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