| 1. |
- Elliott, J. A., et al.
(författare)
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Attenuation of satiety gut hormones increases appetitive behavior after curative esophagectomy for esophageal cancer
- 2019
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165. ; 109:2, s. 335-344
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reduced appetite and weight loss are common after esophagectomy (ES), and this cohort demonstrates an exaggerated postprandial satiety gut hormone response. Satiety gut hormones modulate food reward, resulting in reduced energy intake. Objectives: This study aimed to determine the effect of satiety gut hormone modulation by measuring the effect of the somatostatin analog octreotide on appetitive behavior among patients after ES. Methods: In this randomized, double-blind, placebo-controlled crossover study, patients >= 1 y after ES and matched controls received either 1 mL 0.9% saline or 1 mL (100 mu g) octreotide subcutaneously before completing a progressive ratio task. A measure of appetitive behavior, this task requires subjects to undertake progressively increasing amounts of work to obtain a sweet-fat reinforcer; the final completed increment (breakpoint) represents reinforcer reward value. Separate cohorts were studied in the fasted or 1-h postprandial states. Results: Thirty-six subjects (ES, n = 18; matched controls, n = 18) were studied. The ES subjects were 2.5 +/- 0.3 y postoperation and had a weight loss of 14.6% +/- 2.6% and elevated postprandial glucagon-like peptide 1 compared with controls (49.2 +/- 13.4 compared with 20.2 +/- 2.3 pM; P = 0.04). Octreotide did not alter the breakpoint among ES or control subjects when tested in a fasting condition (ES: 980 +/- 371 compared with 1700 +/- 584 clicks; P = 0.16; controls: 1056 +/- 274 compared with 1124 +/- 273 clicks; P = 0.81). When tested 1 h postprandially, octreotide was associated with an increased breakpoint compared with placebo among ES subjects (322 +/- 143 compared with 246 +/- 149 clicks; P = 0.04) but not controls (248 +/- 119 compared with 247 +/- 120 clicks; P = 0.97). Conclusions: Attenuation of the exaggerated postprandial satiety gut hormone response is associated with increased appetitive behavior toward a sweet-fat stimulus among patients post-ES. Suppression of satiety gut hormones may be a novel target to increase appetite, food intake, and body weight among patients after ES.
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| 2. |
- Elliott, J. A., et al.
(författare)
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Changes in gut hormones, glycaemic response and symptoms after oesophagectomy
- 2019
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 106:6, s. 735-746
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oesophagectomy is associated with reduced appetite, weight loss and postprandial hypoglycaemia, the pathophysiological basis of which remains largely unexplored. This study aimed to investigate changes in enteroendocrine function after oesophagectomy. Methods: In this prospective study, 12 consecutive patients undergoing oesophagectomy were studied before and 10 days, 6, 12 and 52weeks after surgery. Serial plasma total fasting ghrelin, and glucagon-like peptide 1 (GLP-1), insulin and glucose release following a standard 400-kcal mixed-meal stimulus were determined. CT body composition and anthropometry were assessed, and symptom scores calculated using European Organisation for Research and Treatment of Cancer (EORTC) questionnaires. Results: At 1 year, two of the 12 patients exhibited postprandial hypoglycaemia, with reductions in bodyweight (mean(s. e. m.) 17.1(3.2) per cent, P < 0.001), fat mass (21.5(2.5) kg versus 25.5(2.4) kg before surgery; P = 0.014), lean body mass (51.5(2.2) versus 54.0(1.8) kg respectively; P = 0.003) and insulin resistance (HOMA-IR: 0.84(0.17) versus 1.16(0.20); P = 0.022). Mean(s. e. m.) fasting ghrelin levels decreased from postoperative day 10, but had recovered by 1 year (preoperative: 621.5(71.7) pg/ml; 10 days: 415.1(59.80) pg/ml; 6weeks: 309.0(42.0) pg/ml; 12weeks: 415.8(52.1) pg/ml; 52weeks: 547.4(83.2) pg/ml; P< 0.001) and did not predict weight loss (P = 0.198). Postprandial insulin increased progressively at 10 days, 6, 12 and 52weeks (mean(s. e. m.) insulin AUC0-30 min: fold change 1.7(0.4), 2.0(0.4), 3.5(0.7) and 4.0(0.8) respectively; P = 0.001). Postprandial GLP-1 concentration increased from day 10 after surgery (P < 0.001), with a 3.3(1.8)-fold increase at 1 year (P < 0.001). Peak GLP-1 level was inversely associated with the postprandial glucose nadir (P = 0.041) and symptomatic neuroglycopenia (Sigstad score, P = 0.017, R2 = 0.45). GLP-1 AUC predicted loss of weight (P = 0.008, R2 = 0.52) and fat mass (P = 0.010, R2 = 0.64) at 1 year. Conclusion: Altered enteroendocrine physiology is associated with early satiety, weight loss and postprandial hypoglycaemia after oesophagectomy.
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| 3. |
- Elliott, J. A., et al.
(författare)
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Weight Loss, Satiety, and the Postprandial Gut Hormone Response After Esophagectomy A Prospective Study
- 2017
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Ingår i: Annals of Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 0003-4932. ; 266:1, s. 82-90
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. Background: With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety and weight loss are common after esophagectomy, but the pathophysiology of these phenomena remains poorly understood. Methods: In this prospective study, consecutive patients undergoing esophagectomy with gastric conduit reconstruction were studied preoperatively and at 10 days, 6 weeks, and 3 months postoperatively. Glucagon-like peptide 1 (GLP-1) immunoreactivity of plasma collected immediately before and at 15, 30, 60, 90, 120, 150, and 180 minutes after a standardized 400-kcal mixed meal was determined. Gastrointestinal symptom scores were computed using European Organization for Research and Treatment of Cancer questionnaires. Results: Body weight loss at 6 weeks and 3 months postoperatively among 13 patients undergoing esophagectomy was 11.1 +/- 2.3% (P < 0.001) and 16.3 +/- 2.2% (P < 0.0001), respectively. Early satiety (P = 0.043), gastrointestinal pain and discomfort (P = 0.01), altered taste (P = 0.006), and diarrhea (P = 0.038) scores increased at 3 months postoperatively. Area under the curve for the satiety gut hormone GLP-1 was significantly increased from 10 days postoperatively (2.4 +/- 0.2-fold increase, P < 0.01), and GLP-1 peak increased 3.8 +/- 0.6-, 4.7 +/- 0.8-, and 4.4 +/- 0.5-fold at 10 days, 6 weeks, and 3 months postoperatively (all P < 0.0001). Three months postoperatively, GLP-1 area under the curve was associated with early satiety (P = 0.0002, R-2 = 0.74), eating symptoms (P = 0.007, R-2 = 0.54), and trouble enjoying meals (P = 0.0004, R-2 = 0.73). Conclusions: After esophagectomy, patients demonstrate an exaggerated postprandial satiety gut hormone response, which may mediate postoperative changes in satiety, body weight, and gastrointestinal quality of life.
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| 4. |
- Evangeliou, N., et al.
(författare)
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Wildfires in northern Eurasia affect the budget of black carbon in the Arctic - a 12-year retrospective synopsis (2002-2013)
- 2016
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Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 16:12, s. 7587-7604
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Tidskriftsartikel (refereegranskat)abstract
- In recent decades much attention has been given to the Arctic environment, where climate change is happening rapidly. Black carbon (BC) has been shown to be a major component of Arctic pollution that also affects the radiative balance. In the present study, we focused on how vegetation fires that occurred in northern Eurasia during the period of 2002-2013 influenced the budget of BC in the Arctic. For simulating the transport of fire emissions from northern Eurasia to the Arctic, we adopted BC fire emission estimates developed independently by GFED3 (Global Fire Emissions Database) and FEI-NE (Fire Emission Inventory - northern Eurasia). Both datasets were based on fire locations and burned areas detected by MODIS (Moderate resolution Imaging Spectroradiometer) instruments on NASA's (National Aeronautics and Space Administration) Terra and Aqua satellites. Anthropogenic sources of BC were adopted from the MACCity (Monitoring Atmospheric Composition and Climate and megacity Zoom for the Environment) emission inventory. During the 12-year period, an average area of 250aEuro-000aEuro-km(2)aEuro-yr(-1) was burned in northern Eurasia (FEI-NE) and the global emissions of BC ranged between 8.0 and 9.5aEuro-TgaEuro-yr(-1) (FEI-NE+MACCity). For the BC emitted in the Northern Hemisphere (based on FEI-NE+MACCity), about 70aEuro-% originated from anthropogenic sources and the rest from biomass burning (BB). Using the FEI-NE+MACCity inventory, we found that 102aEuro-+/- aEuro-29aEuro-ktaEuro-yr(-1) BC was deposited in the Arctic (defined here as the area north of 67A degrees aEuro-N) during the 12 years simulated, which was twice as much as when using the MACCity inventory (56aEuro-+/- aEuro-8aEuro-ktaEuro-yr(-1)). The annual mass of BC deposited in the Arctic from all sources (FEI-NE in northern Eurasia, MACCity elsewhere) is significantly higher by about 37aEuro-% in 2009 (78 vs. 57aEuro-ktaEuro-yr(-1)) to 181aEuro-% in 2012 (153 vs. 54aEuro-ktaEuro-yr(-1)), compared to the BC deposited using just the MACCity emission inventory. Deposition of BC in the Arctic from BB sources in the Northern Hemisphere thus represents 68aEuro-% of the BC deposited from all BC sources (the remaining being due to anthropogenic sources). Northern Eurasian vegetation fires (FEI-NE) contributed 85aEuro-% (79-91aEuro-%) to the BC deposited over the Arctic from all BB sources in the Northern Hemisphere. We estimate that about 46aEuro-% of the BC deposited over the Arctic from vegetation fires in northern Eurasia originated from Siberia, 6aEuro-% from Kazakhstan, 5aEuro-% from Europe, and about 1aEuro-% from Mongolia. The remaining 42aEuro-% originated from other areas in northern Eurasia. About 42aEuro-% of the BC released from northern Eurasian vegetation fires was deposited over the Arctic (annual average: 17aEuro-%) during spring and summer.
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