مجال التميز | بحثي ودراسي |
البحوث المنشورة |
|
البحث (1): | |
عنوان البحث: | Combined GLP-1, oxyntomodulin, and peptide YY improves body weight and
glycemia in obesity and prediabetes/type 2 diabetes: a randomized, single-blinded, placebo-controlled study. |
رابط إلى البحث: | https://pubmed.ncbi.nlm.nih.gov/31177183/ |
تاريخ النشر: | 01/08/2019 |
موجز عن البحث: | OBJECTIVE
Roux-en-Y gastric bypass (RYGB) augments postprandial secretion of glucagon-like peptide 1 (GLP-1), oxyntomodulin (OXM), and peptide YY (PYY). Subcutaneous infusion of these hormones (“GOP”), mimicking postprandial levels, reduces energy intake. Our objective was to study the effects of GOP on glycemia and body weight when given for 4 weeks to patients with diabetes and obesity. RESEARCH DESIGN AND METHODS In this single-blinded mechanistic study, obese patients with prediabetes/diabetes were randomized to GOP (n = 15) or saline (n = 11) infusion for 4 weeks. We also studied 21 patients who had undergone RYGB and 22 patients who followed a very low-calorie diet (VLCD) as unblinded comparators. Outcomes measured were 1) body weight, 2) fructosamine levels, 3) glucose and insulin during a mixed meal test (MMT), 4) energy expenditure (EE), 5) energy intake (EI), and 6) mean glucose and measures of glucose variability during continuous glucose monitoring. RESULTS GOP infusion was well tolerated over the 4-week period. There was a greater weight loss (P = 0.025) with GOP (mean change −4.4 [95% CI −5.3, −3.5] kg) versus saline (−2.5 [−4.1, −0.9] kg). GOP led to a greater improvement (P = 0.0026) in fructosamine (−44.1 [−62.7, −25.5] µmol/L) versus saline (−11.7 [−18.9, −4.5] µmol/L). Despite a smaller weight loss compared with RYGB and VLCD, GOP led to superior glucose tolerance after a mixed-meal stimulus and reduced glycemic variability compared with RYGB and VLCD. CONCLUSIONS GOP infusion improves glycemia and reduces body weight. It achieves superior glucose tolerance and reduced glucose variability compared with RYGB and VLCD. GOP is a viable alternative for the treatment of diabetes with favorable effects on body weight. |
البحث (2): | |
عنوان البحث: | Pregnancy loss of control over eating: a longitudinal study of maternal and child outcomes |
رابط إلى البحث: | https://academic.oup.com/ajcn/article/108/1/101/5026246?login=true |
تاريخ النشر: | 05/06/2018 |
موجز عن البحث: | Background
To our knowledge, no previous studies have investigated longitudinal outcomes of maternal loss of control over eating (LOC) in pregnancy in a general population sample. Objective We aimed to determine whether pregnancy LOC is associated with dietary, gestational weight gain, and offspring birth-weight outcomes in a large population-based prospective study of pregnant women and their children. We also explored the association with offspring weight at age 15.5 y. Design Women (n = 11,132) from the Avon Longitudinal Study of Parents and Children (ALSPAC) were included. Crude and adjusted logistic and multinomial regression models were used. LOC in pregnancy and diet at 32 wk of gestation were assessed by self-report. Pregnancy weight gain and birth weight were obtained from obstetric records. Child weight and height were objectively measured at age 15.5 y. Results LOC in pregnancy was common (36.3%). Women with pregnancy LOC reported higher total energy intake, consumed more snacks, and had lower vitamin B-6, A, and C intake compared with women without LOC. Women with frequent LOC had lower vitamin B-1 and folate intake [respectively: b = −0.05 (95% CI: −0.07, −0.02) and b = −7.1 (95% CI: −11.8, −2.3) in adjusted analyses], and gained on average 3.74 kg (95% CI: 3.33, 4.13 kg) more than women without LOC. Frequent and occasional LOC were associated with higher birth weight [respectively: b = 0.07 (95% CI: 0.03, 0.1), b = 0.04 (95% CI: 0.02, 0.06)]. Offspring of mothers with frequent pregnancy LOC had 2-fold increased odds of being overweight/obese at 15.5 y [OR = 2.02 (95% CI: 1.37, 3.01)]. Conclusions Pregnancy LOC eating is common and has an adverse short- and long-term impact on mother and offspring, but has received very limited attention. Our findings further the understanding of risk factors for obesity and highlight a need for improved identification of maternal pregnancy loss of control eating. This trial was registered at clinicaltrials.gov as NCT03269253.
|
المؤتمرات العلمية |
|
المؤتمر (1): | |
عنوان المؤتمر: | British Endocrine Society Conference |
تاريخ الإنعقاد: | 06/11/2019 |
مكان الإنعقاد: | Brighton, United Kingdom
|
طبيعة المشاركة: | PRESENTATION |
عنوان المشاركة: | “The impact of subcutaneous infusions of three anorexigenic gut hormones glucagon-like
peptide-1, oxyntomodulin and peptide YY (GOP) on the psychological health of obese diabetic patients.” |
ملخص المشاركة: | Introduction: Obesity-associated psychopathological co-morbidities have a negative impact on quality of life. Roux-en-Y gastric bypass surgery (RYGB) has been shown to ameliorate psychological health, however, the underlying mechanisms are not fully understood. Changes in gastrointestinal and central neuroendocrine signalling have been postulated as mediators of psychological and eating behaviour changes following RYGB. Here we assess the impact of subcutaneous infusions of three anorexigenic gut hormones glucagon-like peptide-1, oxyntomodulin and peptideYY (GOP) on the psychological health of obese diabetic patients.
Method: In this prospective cohort study, 27 obese diabetic patients were recruited and randomized to GOP (n=16) or saline (n= 11) infusion for 4 weeks. We also studied 16 patients who underwent RYGB. A set of validated questionnaires were used to measure psychological health, eating psychopathology, and quality of life pre- and post-intervention. Results were analysed using two-way ANOVA followed by post-hoc analysis using the Bonferroni method to correct for multiple corrections. Results: Both GOP and RYGB showed an improvement of health-related quality of life related to weight loss. There was a significant increase in restrained eating and a significant reduction in external eating in the GOP group, an improvement on reward and punishment sensitivity assessed by the Behavioural Inhibition System and Behavioural Activation System (BIS/BAS) scales after GOP compared with the saline group. There was a significant improvement in the RYGB group the Power of Food Scale, a questionnaire that measures an individual’s motivation to consume highly palatable foods. These results emphasise the effectiveness of the surgical intervention in ameliorating obesity-related symptoms whilst providing substantial long-lasting weight-loss effects. Conclusion: The improvement in the reward sensitivity post-GOP warrants further research using longer-term studies. The augmented secretion of anorexigenic hormones post RYGB in its own may not be the only mediator for the favourable improvement in psychological health seen after RYGB.
|
المؤتمر (2): | |
عنوان المؤتمر: | Society for Endocrinology BES 2019 |
تاريخ الإنعقاد: | 14/02/2019 |
مكان الإنعقاد: | London, United Kingdom |
طبيعة المشاركة: | PRESENTATION |
عنوان المشاركة: | “Metabolic changes post Roux-En-Y Gastric Bypass: one-year prospective study.” |
ملخص المشاركة: |
Background: Bariatric surgery is currently the most effective treatment for weight loss. Its metabolic effects of weight loss and improvement of type 2 diabetes are mediated mainly through the postprandial elevation of gut hormones such as GLP-1, which suppresses food intake and improves insulin secretion. Aim: To characterize the longitudinal changes in fasting and postprandial secretion of glucose, insulin and gut hormones (GLP-1 and GIP) in patients before and after Roux-en-Y gastric bypass (RYGB). Subjects and Methods: Twenty-one obese patients with type 2 diabetes (Age: 48.2±13.2 years, BMI: 43.2±6.2 kg/m2) were studied before and at 1, 3 and 12 months after RYGB. Glucose, Insulin, GLP-1 and GIP levels were measured at fasting state and during a Mixed Meal Tolerance Test. Results: There was a significant reduction in fasting and postprandial levels of glucose and insulin as early as 1 month post-RYGB. An earlier peak of glucose and insulin was observed at 30 minutes as opposed to the one at 60 minutes prior to bariatric surgery. There was a steady increase in peak GLP-1 levels secreted in response to a mixed meal test (MMT) with time after surgery with an earlier peak at 15 minutes versus the peak seen at 30 minutes preoperatively. There was no significant difference in GIP responses to MMT before and after surgery. Conclusions: Our results confirm, in concordance with the literature, a reduction in fasting and postprandial glucose and insulin levels and an increase in postprandial secretion of GLP-1 after surgery which increases in magnitude with time whereas there is no significant change in GIP secretion with surgery. Interestingly, there is an earlier peak of GLP-1 levels followed by an earlier peak of glucose and insulin levels post-RYGB
|
هياء دخيل الله بن رجاء خالد العصيمي
دكتوراه
الطب والخدمات الصحية
Imperial College London