Francis Martin Finucane , Mohammed Faraz Rafey , Martin Leahy , Paula O'Shea , Tim O'Brien , Martin O'Donnell
{"title":"在接受代餐计划的严重肥胖成人中，体重减轻与空腹血清β -羟基丁酸盐浓度的增加成正比","authors":"Francis Martin Finucane , Mohammed Faraz Rafey , Martin Leahy , Paula O'Shea , Tim O'Brien , Martin O'Donnell","doi":"10.1016/j.hnm.2023.200192","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>A better understanding of the influence of restricted dietary intake on circulating ketone concentrations might help to explain heterogeneity in the amount of weight lost in dietary interventions. We sought to determine the association between the magnitude of weight loss and changes in fasting serum ketone concentrations in adults with severe obesity completing a meal replacement programme.</p></div><div><h3>Methods</h3><p>In this single-centre prospective cohort study, adults with severe and complicated obesity attending our regional bariatric service underwent an eight-week, milk-based, low-energy meal replacement programme. Fasting serum beta-hydroxybutyrate levels were measured with a spectrophotometric assay at baseline and after two- and eight weeks of follow-up.</p></div><div><h3>Results</h3><p>Of 120 patients who started the programme, 74 (62%) completed eight weeks. Of these, 60% were female, mean age was 49.2 ± 11.9 (range 18–75.1) years, mean body mass index was 51.2 ± 10.5 kg<sup>−2</sup>. The median [IQR] total weight loss percentage after eight weeks was 10.2 [8.6, 12.2] %. Fasting serum ketones increased between zero and eight weeks from a median of 95 [70, 140] to 185 [130, 320] μmoL/l (<em>p</em> < 0.0001). For each one percent reduction in body weight at eight weeks, there was a 112.6 [77.4, 147.8] μmoL/l increase in fasting beta-hydroxybutyrate concentrations, (<em>p</em> < 0.0001). We found similar associations between weight loss at eight weeks and increases in ketones at two weeks. However, with receiver operating characteristics (ROC) curve analyses, changes in ketones at two weeks were not a strong predictor of attaining 5% or 10% weight loss at eight weeks.</p></div><div><h3>Discussion</h3><p>In a specialist bariatric clinic-based cohort of Irish adults with severe and complicated obesity, the amount of weight lost at eight weeks was proportional to increases in fasting beta-hydroxybutyrate concentrations after two and eight weeks of milk-based, low-energy meal replacement, but early changes in fasting ketones were not a good predictor of subsequent intervention success.</p></div>","PeriodicalId":36125,"journal":{"name":"Human Nutrition and Metabolism","volume":"32 ","pages":"Article 200192"},"PeriodicalIF":1.9000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Weight loss is proportional to increases in fasting serum beta-hydroxybutyrate concentrations in adults with severe obesity undergoing a meal replacement programme\",\"authors\":\"Francis Martin Finucane , Mohammed Faraz Rafey , Martin Leahy , Paula O'Shea , Tim O'Brien , Martin O'Donnell\",\"doi\":\"10.1016/j.hnm.2023.200192\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>A better understanding of the influence of restricted dietary intake on circulating ketone concentrations might help to explain heterogeneity in the amount of weight lost in dietary interventions. We sought to determine the association between the magnitude of weight loss and changes in fasting serum ketone concentrations in adults with severe obesity completing a meal replacement programme.</p></div><div><h3>Methods</h3><p>In this single-centre prospective cohort study, adults with severe and complicated obesity attending our regional bariatric service underwent an eight-week, milk-based, low-energy meal replacement programme. Fasting serum beta-hydroxybutyrate levels were measured with a spectrophotometric assay at baseline and after two- and eight weeks of follow-up.</p></div><div><h3>Results</h3><p>Of 120 patients who started the programme, 74 (62%) completed eight weeks. Of these, 60% were female, mean age was 49.2 ± 11.9 (range 18–75.1) years, mean body mass index was 51.2 ± 10.5 kg<sup>−2</sup>. The median [IQR] total weight loss percentage after eight weeks was 10.2 [8.6, 12.2] %. Fasting serum ketones increased between zero and eight weeks from a median of 95 [70, 140] to 185 [130, 320] μmoL/l (<em>p</em> < 0.0001). For each one percent reduction in body weight at eight weeks, there was a 112.6 [77.4, 147.8] μmoL/l increase in fasting beta-hydroxybutyrate concentrations, (<em>p</em> < 0.0001). We found similar associations between weight loss at eight weeks and increases in ketones at two weeks. However, with receiver operating characteristics (ROC) curve analyses, changes in ketones at two weeks were not a strong predictor of attaining 5% or 10% weight loss at eight weeks.</p></div><div><h3>Discussion</h3><p>In a specialist bariatric clinic-based cohort of Irish adults with severe and complicated obesity, the amount of weight lost at eight weeks was proportional to increases in fasting beta-hydroxybutyrate concentrations after two and eight weeks of milk-based, low-energy meal replacement, but early changes in fasting ketones were not a good predictor of subsequent intervention success.</p></div>\",\"PeriodicalId\":36125,\"journal\":{\"name\":\"Human Nutrition and Metabolism\",\"volume\":\"32 \",\"pages\":\"Article 200192\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Human Nutrition and Metabolism\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666149723000099\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Nutrition and Metabolism","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666149723000099","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Weight loss is proportional to increases in fasting serum beta-hydroxybutyrate concentrations in adults with severe obesity undergoing a meal replacement programme
Background
A better understanding of the influence of restricted dietary intake on circulating ketone concentrations might help to explain heterogeneity in the amount of weight lost in dietary interventions. We sought to determine the association between the magnitude of weight loss and changes in fasting serum ketone concentrations in adults with severe obesity completing a meal replacement programme.
Methods
In this single-centre prospective cohort study, adults with severe and complicated obesity attending our regional bariatric service underwent an eight-week, milk-based, low-energy meal replacement programme. Fasting serum beta-hydroxybutyrate levels were measured with a spectrophotometric assay at baseline and after two- and eight weeks of follow-up.
Results
Of 120 patients who started the programme, 74 (62%) completed eight weeks. Of these, 60% were female, mean age was 49.2 ± 11.9 (range 18–75.1) years, mean body mass index was 51.2 ± 10.5 kg−2. The median [IQR] total weight loss percentage after eight weeks was 10.2 [8.6, 12.2] %. Fasting serum ketones increased between zero and eight weeks from a median of 95 [70, 140] to 185 [130, 320] μmoL/l (p < 0.0001). For each one percent reduction in body weight at eight weeks, there was a 112.6 [77.4, 147.8] μmoL/l increase in fasting beta-hydroxybutyrate concentrations, (p < 0.0001). We found similar associations between weight loss at eight weeks and increases in ketones at two weeks. However, with receiver operating characteristics (ROC) curve analyses, changes in ketones at two weeks were not a strong predictor of attaining 5% or 10% weight loss at eight weeks.
Discussion
In a specialist bariatric clinic-based cohort of Irish adults with severe and complicated obesity, the amount of weight lost at eight weeks was proportional to increases in fasting beta-hydroxybutyrate concentrations after two and eight weeks of milk-based, low-energy meal replacement, but early changes in fasting ketones were not a good predictor of subsequent intervention success.
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