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Changes in Gut Microbiota–Related Metabolites and Long-term Successful Weight Loss in Response to Weight-Loss Diets: The POUNDS Lost Trial
Diabetes Care ( IF 16.2 ) Pub Date : 2018-03-01 , DOI: 10.2337/dc17-2108
Yoriko Heianza 1 , Dianjianyi Sun 1 , Steven R. Smith 2 , George A. Bray 3 , Frank M. Sacks 4 , Lu Qi 1, 4
Affiliation  

OBJECTIVE Adiposity and the gut microbiota are both related to the risk of type 2 diabetes. We aimed to comprehensively examine how changes induced by a weight-loss diet intervention in gut microbiota–related metabolites, such as trimethylamine N-oxide (TMAO) and its precursors (choline and l-carnitine), were associated with improvements in adiposity and regional fat deposition.

RESEARCH DESIGN AND METHODS This study included 510 overweight and obese individuals who were randomly assigned one of four diets varying in macronutrient intake. We examined associations of 6-month changes in blood metabolites (TMAO, choline, and l-carnitine) with improvements in body weight (BW), waist circumference (WC), body fat composition, fat distribution, and resting energy expenditure (REE).

RESULTS Individuals with a greater reduction of choline (P < 0.0001) and l-carnitine (P < 0.01) rather than TMAO showed significant losses of BW and WC at 6 months. The reduction of choline was significantly predictive of decreases in body fat composition, fat distribution, and REE. Results of sensitivity analysis showed that the baseline diabetes risk status, such as the presence of hyperglycemia (31% of the total participants) and fasting glucose levels, did not modify the associations. Early changes in choline and l-carnitine were significantly predictive of weight loss over 2 years (P < 0.05 for all). Individuals with increases in choline or l-carnitine were 2.35-times (95% CI 1.38, 4.00) or 1.77-times (1.06, 2.95) more likely to fail to lose weight (–5% or more loss) at 2 years.

CONCLUSIONS Overweight and obese individuals who showed decreases in circulating choline or l-carnitine levels achieved greater improvements of adiposity and energy metabolism by eating a low-calorie weight-loss diet, suggesting that such metabolites are predictive of individuals’ response to the treatment. Further investigations are necessary to confirm our findings, particularly in a population with prediabetes that is more representative of the U.S. population with obesity.



中文翻译:

肠道微生物群相关代谢产物的变化和长期成功减肥对体重减轻饮食的反应:POUNDS失去的试验

目的肥胖和肠道菌群均与2型糖尿病的风险有关。我们旨在全面研究减肥饮食干预对肠道微生物群相关代谢产物(如三甲胺N-氧化物(TMAO)及其前体(胆碱和1-肉碱))的改变与肥胖症和局部肥胖的改善之间的关系。脂肪沉积。

研究设计与方法该研究纳入了510名超重和肥胖的个体,这些个体被随机分配为多种营养素摄入量不同的四种饮食之一。我们检查了在血液代谢物6个月的改变(TMAO,胆碱,和协会与体重的改进(BW),腰围(WC),体脂肪组合物,脂肪分布,和静息能量消耗肉碱)(REE) 。

结果在6个月时,胆碱(P <0.0001)和l-肉碱(P <0.01)而不是TMAO降低的个体表现出明显的BW和WC损失。胆碱的减少明显预示着体内脂肪成分,脂肪分布和REE的降低。敏感性分析结果表明,基线糖尿病风险状态,例如高血糖症的存在(占总参与者的31%)和空腹血糖水平,并未改变这种关联。在胆碱和早期变化肉碱都是显著预测超过2年(重量损失的P <0.05对于所有)。胆碱或l升高的个体-肉碱在2年内未能减肥的机率提高了2.35倍(95%CI 1.38,4.00)或1.77倍(1.06,2.95)。

结论超重和肥胖的人谁循环胆碱或呈下降肉碱水平吃低卡路里的减肥食谱获得肥胖和能量代谢的更大的改善,这表明这种代谢产物是预测个体对治疗的反应。需要进一步的研究来证实我们的发现,尤其是在糖尿病前期人群中,该人群更能代表美国的肥胖人群。

更新日期:2018-02-21
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