Metabolic effects of an essential amino acid supplement in adolescents with PCOS and obesity

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Obesity Pub Date : 2024-03-04 DOI:10.1002/oby.23988

Talyia M. Fordham, Nazeen S. Morelli, Yesenia Garcia-Reyes, Meredith A. Ware, Haseeb Rahat, Divya Sundararajan, Kelly N. Z. Fuller, Cameron Severn, Laura Pyle, Craig R. Malloy, Eunsook S. Jin, Elizabeth J. Parks, Robert R. Wolfe, Melanie G. Cree

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Abstract

Objective

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, insulin resistance, and hepatic steatosis (HS). Because dietary essential amino acid (EAA) supplementation has been shown to decrease HS in various populations, this study's objective was to determine whether supplementation would decrease HS in PCOS.

Methods

A randomized, double-blind, crossover, placebo-controlled trial was conducted in 21 adolescents with PCOS (BMI 37.3 ± 6.5 kg/m², age 15.6 ± 1.3 years). Liver fat, very low-density lipoprotein (VLDL) lipogenesis, and triacylglycerol (TG) metabolism were measured following each 28-day phase of placebo or EAA.

Results

Compared to placebo, EAA was associated with no difference in body weight (p = 0.673). Two markers of liver health improved: HS was lower (−0.8% absolute, −7.5% relative reduction, p = 0.013), as was plasma aspartate aminotransferase (AST) (−8%, p = 0.004). Plasma TG (−9%, p = 0.015) and VLDL-TG (−21%, p = 0.031) were reduced as well. VLDL-TG palmitate derived from lipogenesis was not different between the phases, nor was insulin sensitivity (p > 0.400 for both). Surprisingly, during the EAA phase, participants reported consuming fewer carbohydrates (p = 0.038) and total sugars (p = 0.046).

Conclusions

Similar to studies in older adults, short-term EAA supplementation in adolescents resulted in significantly lower liver fat, AST, and plasma lipids and thus may prove to be an effective treatment in this population. Additional research is needed to elucidate the mechanisms for these effects.

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一种必需氨基酸补充剂对多囊卵巢综合症和肥胖症青少年的代谢影响。

目的：多囊卵巢综合征（PCOS）的特征是高雄激素、胰岛素抵抗和肝脂肪变性（HS）。由于在不同人群中补充膳食必需氨基酸（EAA）可降低HS，本研究的目的是确定补充必需氨基酸是否会降低多囊卵巢综合征患者的HS：方法：对 21 名患有多囊卵巢综合征的青少年（体重指数为 37.3 ± 6.5 kg/m2，年龄为 15.6 ± 1.3 岁）进行了随机、双盲、交叉、安慰剂对照试验。在每28天服用安慰剂或EAA后，测量肝脏脂肪、极低密度脂蛋白（VLDL）脂肪生成和三酰甘油（TG）代谢：结果：与安慰剂相比，EAA 与体重无差别（p = 0.673）。肝脏健康的两个指标有所改善：HS降低（绝对降低-0.8%，相对降低-7.5%，p = 0.013），血浆天冬氨酸氨基转移酶（AST）也降低（-8%，p = 0.004）。血浆 TG（-9%，p = 0.015）和 VLDL-TG（-21%，p = 0.031）也有所降低。由脂肪生成的 VLDL-TG 棕榈酸酯在各阶段之间没有差异，胰岛素敏感性也没有差异（两者的 p > 0.400）。令人惊讶的是，在 EAA 阶段，参与者报告摄入的碳水化合物（p = 0.038）和总糖（p = 0.046）更少：与针对老年人的研究相似，青少年短期补充 EAA 可显著降低肝脏脂肪、谷草转氨酶和血浆脂质，因此可能被证明是针对这一人群的有效治疗方法。需要进行更多的研究来阐明产生这些效果的机制。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.