在接受代餐计划的严重肥胖成人中,体重减轻与空腹血清β -羟基丁酸盐浓度的增加成正比

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Human Nutrition and Metabolism Pub Date : 2023-06-01 DOI:10.1016/j.hnm.2023.200192
Francis Martin Finucane , Mohammed Faraz Rafey , Martin Leahy , Paula O'Shea , Tim O'Brien , Martin O'Donnell
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引用次数: 1

摘要

背景:更好地了解限制饮食摄入对循环酮浓度的影响可能有助于解释饮食干预中体重减轻量的异质性。我们试图确定体重减轻的幅度与完成代餐计划的严重肥胖成人空腹血清酮浓度变化之间的关系。方法在这项单中心前瞻性队列研究中,患有严重和复杂肥胖的成年人参加了我们的区域减肥服务,接受了为期8周的低能量牛奶替代餐计划。在基线和随访2周和8周后,用分光光度法测定空腹血清β -羟基丁酸水平。结果在120例患者中,74例(62%)完成了8周治疗。其中女性占60%,平均年龄49.2±11.9(18-75.1)岁,平均体重指数51.2±10.5 kg−2。8周后的中位[IQR]总减重率为10.2%[8.6%,12.2%]。空腹血清酮在0至8周期间从中位数95[70,140]增加到185 [130,320]μmoL/l (p <0.0001)。8周时,体重每减少1%,空腹β -羟基丁酸盐浓度增加112.6 [77.4,147.8]μmoL/l, (p <0.0001)。我们发现在8周的体重下降和2周的酮类增加之间也有类似的联系。然而,通过受试者工作特征(ROC)曲线分析,2周时酮类的变化并不能预测8周时体重减轻5%或10%。在一项针对严重和复杂肥胖的爱尔兰成人的专科减肥临床队列研究中,经过2周和8周以牛奶为基础的低能量膳食替代后,8周体重减轻的量与空腹β -羟基丁酸盐浓度的增加成正比,但空腹酮的早期变化并不能很好地预测后续干预的成功。
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Weight loss is proportional to increases in fasting serum beta-hydroxybutyrate concentrations in adults with severe obesity undergoing a meal replacement programme

Background

A better understanding of the influence of restricted dietary intake on circulating ketone concentrations might help to explain heterogeneity in the amount of weight lost in dietary interventions. We sought to determine the association between the magnitude of weight loss and changes in fasting serum ketone concentrations in adults with severe obesity completing a meal replacement programme.

Methods

In this single-centre prospective cohort study, adults with severe and complicated obesity attending our regional bariatric service underwent an eight-week, milk-based, low-energy meal replacement programme. Fasting serum beta-hydroxybutyrate levels were measured with a spectrophotometric assay at baseline and after two- and eight weeks of follow-up.

Results

Of 120 patients who started the programme, 74 (62%) completed eight weeks. Of these, 60% were female, mean age was 49.2 ± 11.9 (range 18–75.1) years, mean body mass index was 51.2 ± 10.5 kg−2. The median [IQR] total weight loss percentage after eight weeks was 10.2 [8.6, 12.2] %. Fasting serum ketones increased between zero and eight weeks from a median of 95 [70, 140] to 185 [130, 320] μmoL/l (p < 0.0001). For each one percent reduction in body weight at eight weeks, there was a 112.6 [77.4, 147.8] μmoL/l increase in fasting beta-hydroxybutyrate concentrations, (p < 0.0001). We found similar associations between weight loss at eight weeks and increases in ketones at two weeks. However, with receiver operating characteristics (ROC) curve analyses, changes in ketones at two weeks were not a strong predictor of attaining 5% or 10% weight loss at eight weeks.

Discussion

In a specialist bariatric clinic-based cohort of Irish adults with severe and complicated obesity, the amount of weight lost at eight weeks was proportional to increases in fasting beta-hydroxybutyrate concentrations after two and eight weeks of milk-based, low-energy meal replacement, but early changes in fasting ketones were not a good predictor of subsequent intervention success.

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来源期刊
Human Nutrition and Metabolism
Human Nutrition and Metabolism Agricultural and Biological Sciences-Food Science
CiteScore
1.50
自引率
0.00%
发文量
30
审稿时长
188 days
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