Functional Brain Imaging and Appetite-Related Hormones Pre and Post Obesity Surge

肥胖激增前后的功能性脑成像和食欲相关激素

• 批准号: 7643687
• 负责人: ALLAN GELIEBTER
• 金额: $ 16.26万
• 依托单位: ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-17 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7643687
• 关键词: Acetaminophen; Area; Binge Eating; Binge eating disorder; Biolectric Impedance; Biological; Blood; Blood Pressure; Body Composition; Body Weight; Body Weight Changes; Body Weight decreased; Body fat; Brain; Brain imaging; Bypass; C-reactive protein; Caliber; Central obesity; Control Groups; Desire for food; Diet; Eating; Eating Behavior; Eating Disorders; Enrollment; Ensure; Exhibits; Fasting; Female; Food; Food Energy; Formula Diets; Functional Magnetic Resonance Imaging; Gastric Bypass; Gastric Emptying; Gender; Glucose; Health; Hip region structure; Hormones; Hunger; Hypothalamic structure; Insulin; Insulin Resistance; Intestinal Bypasses; Intestines; Invasive; Knowledge; Lead; Leptin; Limb structure; Lipids; Liquid substance; Magnetic Resonance Imaging; Measurement; Measures; Metabolic syndrome; Motor; Obesity; Operative Surgical Procedures; Outcome; Participant; Patients; Peptide YY; Peptides; Phase; Plasma; Prefrontal Cortex; Pylorus; Race; Range; Rate; Relative (related person); Rewards; Risk Factors; Satiation; Scanning; Sensory; Stimulus; Stomach; Symptoms; Syndrome; Time; Visual; Vomiting; Weight; Width; Woman; abstracting; adiponectin; anorexigenic peptide; auditory stimulus; bariatric surgery; base; comparison group; desire; experience; ghrelin; glucagon-like peptide 1; improved; indexing; insight; interest; islet amyloid polypeptide; male; men; non-diabetic; peptide hormone; resistin; response; size; waist circumference

Abstract: This is a study employing functional magnetic resonance imaging (fMRI) and measures of appetiterelated hormone concentrations pre and post bariatric surgery. The mechanisms of reduced food intake and weight loss after obesity surgery are not well understood. Participants will be studied prior to surgery as well as 3 mo and 18 mo following the two most common operations world wide: laparoscopic gastric bypass (RYGB) and laparoscopic adjustable gastric banding (GB). These two operative groups will be compared to two control groups: 1) active weight loss on a formula diet (WL) for 3 mo; and 2) candidates for surgery who do not have an operation, or no treatment (NT). fMRI will be used to examine areas of brain activation in response to visual and auditory stimuli of palatable high energy foods, less palatable low energy foods, and non foods. At 3 mo, relative to study baseline, it is expected that there will be reduced activation in key brain areas, such as the prefrontal cortex, in response to the high-energy food stimuli after RYGB. In contrast, there should be an increase in activation in these areas after GB and to an even greater extent in WL and no change in NT. There will be some return in brain activation to baseline by 18 mo, especially for WL with expected weight regain, and no changes in NT. Both surgical operations restrict the size of the stomach, but RYGB is much more invasive than GB and involves sectioning the stomach and bypassing a segment of the intestine. The sectioning of the stomach may lead to lower levels of the orexigenic hormone, ghrelin, produced mainly by the stomach, and combined with the intestinal bypass, to higher post meal levels of the anorexigenic hormones, PYY and GLP-1. Hormones will be measured prior to and after a fixed liquid meal at each of the three time points. It is expected that GB, and to a greater extent WL, will experience changes in these hormones in the opposite direction from RYGB at 3 mo relative to study baseline, with some return to this baseline at 18 mo. As a secondary aim, we will assess eating disorders, focusing on binge eating disorder (BED), which are expected to decline the most after RYGB but to start to return at 18 mo. Presurgery eating disorders, particularly BED, and their changes post surgery will be examined and related to changes in brain activation, gut hormones, and weight loss. We will enroll 128 relatively healthy (nondiabetic) clinically severe obese men and women with a BMI of 40-50, with 32 RYGB, 32 GB, 32 WL, and 32 NT. The BMI range will ensure that virtually all S¿s will fit into the scanner. All four groups will be matched for BMI and for female to male ratio of about 3 to1, as well as for race. The findings should improve our knowledge of the biological mechanisms that contribute to appetite and weight reduction after bariatric surgery. This may lead to improvements in the surgical procedures and to new insights into basic mechanisms that lead to obesity, which could provide the basis for new less invasive treatments.

摘要：这是一项利用功能磁共振成像（fMRI）和食欲相关测量的研究 减肥手术前后的激素浓度减少食物摄入量的机制。 肥胖手术后的体重减轻尚不十分清楚，参与者将在手术前以及 3 进行研究。 世界上最常见的两种手术后的 18 个月和 18 个月：腹腔镜胃绕道手术 (RYGB) 和 将这两个手术组与两个对照组进行比较。 组：1) 配方饮食主动减肥 (WL) 3 个月；2) 没有体重的手术候选人； 手术或不治疗（NT）将用于检查对视觉和视觉反应的大脑激活区域。 相对而言，可口的高能量食物、不太可口的低能量食物和非食物的听觉刺激。 为了研究基线，预计关键大脑区域的激活将会减少，例如前额叶 相比之下，RYGB 后皮质对高能量食物刺激的反应应该有所增加。 GB 后这些区域的激活以及 WL 中的激活程度更大，而 NT 中则没有变化。 大脑激活在 18 个月后恢复到基线，特别是对于预期体重恢复的 WL，并且 NT 两种手术都会限制胃的大小，但 RYGB 比 GB 和 GB 更具侵入性。 涉及切开胃并绕过一段肠道。 导致食欲激素（胃饥饿素）水平降低，该激素主要由胃产生，并与 肠旁路手术，会导致餐后厌食激素、PYY 和 GLP-1 水平升高。 预计在三个时间点的每一个固定流质餐之前和之后进行测量。 更大程度的 WL，将在 3 个月时经历与 RYGB 相反方向的这些激素变化 相对于研究基线，部分人会在 18 个月时恢复到该基线 作为次要目标，我们将评估饮食。 暴食症（BED），预计在 RYGB 之后下降最多，但开始 术后 18 个月恢复饮食失调，尤其是 BED，其术后变化将是 检查并与大脑激活、肠道激素和体重减轻的变化相关。我们将相对招募 128 名。 BMI 为 40-50、32 RYGB、32 GB、32 WL 的健康（非糖尿病）临床严重肥胖男性和女性， BMI 范围将确保几乎所有 S¿ s 将适合扫描仪。所有四个组都将匹配。 对于 BMI 和女性与男性的比例约为 3 比 1，以及种族，研究结果应该会改善我们的情况。 了解减肥手术后有助于食欲和体重减轻的生物机制。 这可能会导致外科手术的改进，并对导致手术的基本机制产生新的见解。 肥胖，这可以为新的微创治疗提供基础。