The effect of a subcutaneous infusion of GLP-1, OXM, and PYY on energy intake and expenditure in obese volunteers
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background:
Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment of obesity, although limited by availability and operative risk. The gut hormones Glucagon-like peptide-1 (GLP-1), Peptide YY (PYY), and Oxyntomodulin (OXM) are elevated postprandially after RYGB, which has been postulated to contribute to its metabolic benefits.
Objective:
We hypothesized that infusion of the three gut hormones to achieve levels similar to those encountered postprandially in RYGB patients might be effective in suppressing appetite. The aim of this study was to investigate the effect of a continuous infusion of GLP-1, OXM, and PYY (GOP) on energy intake and expenditure in obese volunteers.
Methods:
Obese volunteers were randomized to receive an infusion of GOP or placebo in a single-blinded, randomized, placebo-controlled crossover study for 10.5 hours a day. This was delivered subcutaneously using a pump device, allowing volunteers to remain ambulatory. Ad libitum food intake studies were performed during the infusion, and energy expenditure was measured using a ventilated hood calorimeter.
Results:
Postprandial levels of GLP-1, OXM, and PYY seen post RYGB were successfully matched using 4 pmol/kg/min, 4 pmol/kg/min, and 0.4 pmol/kg/min, respectively. This dose led to a mean reduction of 32% in food intake. No significant effects on resting energy expenditure were observed.
Conclusion:
This is, to our knowledge, the first time that an acute continuous subcutaneous
Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment of obesity, although limited by availability and operative risk. The gut hormones Glucagon-like peptide-1 (GLP-1), Peptide YY (PYY), and Oxyntomodulin (OXM) are elevated postprandially after RYGB, which has been postulated to contribute to its metabolic benefits.
Objective:
We hypothesized that infusion of the three gut hormones to achieve levels similar to those encountered postprandially in RYGB patients might be effective in suppressing appetite. The aim of this study was to investigate the effect of a continuous infusion of GLP-1, OXM, and PYY (GOP) on energy intake and expenditure in obese volunteers.
Methods:
Obese volunteers were randomized to receive an infusion of GOP or placebo in a single-blinded, randomized, placebo-controlled crossover study for 10.5 hours a day. This was delivered subcutaneously using a pump device, allowing volunteers to remain ambulatory. Ad libitum food intake studies were performed during the infusion, and energy expenditure was measured using a ventilated hood calorimeter.
Results:
Postprandial levels of GLP-1, OXM, and PYY seen post RYGB were successfully matched using 4 pmol/kg/min, 4 pmol/kg/min, and 0.4 pmol/kg/min, respectively. This dose led to a mean reduction of 32% in food intake. No significant effects on resting energy expenditure were observed.
Conclusion:
This is, to our knowledge, the first time that an acute continuous subcutaneous
Date Issued
2017-07-01
Date Acceptance
2017-03-30
Citation
Journal of Clinical Endocrinology and Metabolism, 2017, 102 (7), pp.2364-2372
ISSN
0021-972X
Publisher
Endocrine Society
Start Page
2364
End Page
2372
Journal / Book Title
Journal of Clinical Endocrinology and Metabolism
Volume
102
Issue
7
Copyright Statement
© 2017, the authors. This article has been published under the terms of the Creative Commons Attribution License (CC BY; https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright for this article is retained by the author(s).
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Sponsor
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Imperial Health Charity
Imperial College Healthcare NHS Trust - CLRN Funding
Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council (MRC)
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000405621600029&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
MR/K02115X/1
RDC06 79560
RDA11 79560
P31576
7006/R50U
RDC06 79560
G0802390
G1000474
MR/J010731/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
GLUCAGON-LIKE PEPTIDE-1
GASTRIC BYPASS-SURGERY
PLACEBO-CONTROLLED TRIAL
FOOD-INTAKE
BARIATRIC SURGERY
WEIGHT MANAGEMENT
EATING BEHAVIOR
OXYNTOMODULIN
APPETITE
HUMANS
Publication Status
Published
Date Publish Online
2017-04-04