Macronutrient Regulation of Ghrelin and Peptide YY in Pediatric Obesity and Prader-Willi Syndrome

Balikcioglu, Pinar Gumus; Balikcioglu, Metin; Muehlbauer, Michael J.; Purnell, Jonathan Q.; Broadhurst, David; Freemark, Michael; Haqq, Andrea M.

doi:10.1210/jc.2015-2503

Cited by 17 publications

(16 citation statements)

References 41 publications

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“…This is followed by a period of hyperphagia and progressive increases in body fat content. The hyperphagia and adiposity in PWS children are associated with hyperleptinemia, hyperghrelinemia and a blunted peptide YY response to high‐fat (58%) feeding . Likewise, the rise in PYY was attenuated in PWS adults following a high calorie chocolate snack containing 61% carbohydrate and 31% fat .…”

Section: Discussionmentioning

confidence: 99%

“…Dietary fat stimulates an increase in GLP‐1 secretion, with a potency equal to or greater than that of dietary carbohydrate or protein . Conversely, dietary nutrients suppress ghrelin secretion, with carbohydrate being more potent, at least in obese children, than fat . Given that GLP‐1 reduces and ghrelin promotes food intake in rodents and humans, the increases in GLP‐1 and reductions in the ratio of ghrelin to GLP‐1 in PWS fed a LC diet might serve to limit food intake and weight gain.…”

Section: Discussionmentioning

confidence: 99%

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Hormonal and metabolic effects of carbohydrate restriction in children with Prader‐Willi syndrome

Irizarry

Mager

Triador

et al. 2019

Clinical Endocrinology

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Objective: Macronutrient regulation of hyperphagia and adiposity in Prader-Willi syndrome (PWS) is poorly understood. We compared fasting and postprandial concentrations of hormones and metabolites in eight PWS children (age 9-18 years) fed, in random order, low carbohydrate, high-fat (LC, 15% carb; 65% fat; 20% protein) and low-fat, high carbohydrate (LF, 65% carb, 15% fat, 20% protein) diets matched for calories and protein.Methods: Participants were randomized to consume either the LC or LF diet during a first hospital admission and the second diet during a subsequent admission. Blood samples were obtained after overnight fasting and 1 hour after a mixed meal.Results: Relative to subjects consuming the LF diet, subjects consuming the LC diet had: lower postprandial insulin concentrations (P = 0.02); higher fasting GLP-1 AND GIP concentrations and increased postprandial GLP-1 (P < 0.02); reduced ratio of fasting ghrelin to GLP-1 (P = 0.0078); increased FFA and fatty acid oxidation, as assessed by concentrations of even-chain acylcarnitines (P < 0.001); lower fasting TG and TG/HDL ratio (P < 0.01); and higher concentrations of branch chain amino acids (P < 0.01). There were no changes in glucose, PYY, or adiponectin. CRP, AST and ALT were all higher (P < 0.01) on the LC diet.Conclusions: Increases in GLP-1 with low carbohydrate feeding and reductions in the ratio of ghrelin to GLP-1 might limit food intake and improve glycaemic control in PWS. Other potential benefits of carbohydrate restriction may include fat mobilization and oxidation and reductions in the TG/HDL ratio, a marker of insulin resistance.However, increases in CRP, AST and ALT necessitate longer-term studies of low carbohydrate efficacy and safety. K E Y W O R D Sbranch chain amino acids, ghrelin, GLP-1, GIP, insulin, low carbohydrate diet, Prader-Willi syndrome, PYY

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hormonal and metabolic effects of carbohydrate restriction in children with Prader‐Willi syndrome

Irizarry

Mager

Triador

et al. 2019

Clinical Endocrinology

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, recent studies suggest the relationship between morbid obesity and development of T2D is more complex and appears to differ in PWS versus non-PWS individuals. For example, in PWS children compared to BMI-matched controls, the insulin response to both a mixed meal and an oral glucose load is lower 14 . Additionally, first and second phase insulin secretion were significantly lower in PWS adults compared to obese controls during an intravenous glucose tolerance test (IVGTT) 76 .…”

Section: Hypothalamic Pituitary Function In Pwsmentioning

confidence: 99%

“…Finally, recent studies from our lab have assessed the acute effects of varying macronutrient content (high fat (HF) or high carbohydrate (HC) iso-caloric breakfast meals) in a randomized cross-over study of 14 PWS and 14 age and BMI-z matched obese controls (OC) 14 . Relative to OC, PWS children had lower fasting insulin and higher fasting ghrelin and ghrelin/PYY.…”

Section: Control Of Food Intake In Prader Willi Syndromementioning

confidence: 99%

“…The dietary composition of macronutrients optimal for metabolic control (e.g. maximizing degree and duration of ghrelin suppression and optimizing insulin sensitivity) in PWS remains to be determined and is the subject of our groups’ ongoing work 127 . Finally, an accurate pictorial assessment tool for appetite, satiety and degree of hyperphagia in PWS is also the subject of ongoing research in our group.…”

Section: Current Standard Therapiesmentioning

confidence: 99%

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