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Dose-related Effects of Calcium to Enhance the Effects of L-tryptophan on Gut Hormones and Energy Intake in Obesity.

  • 2025-08-01
  • The Journal of clinical endocrinology and metabolism 110(9)
    • Javad Anjom-Shoae
    • Penelope C E Fitzgerald
    • Michael Horowitz
    • Jens J Holst
    • Jens F Rehfeld
    • Simon Veedfald
    • Christine Feinle-Bisset

Study Design

Type
Randomized Controlled Trial (RCT)
Population
Fifteen males with obesity and without type 2 diabetes (mean ± SD; age: 27 ± 8 years; body mass index: 30 ± 2 kg/m2; hemoglobin A1c: 5.3 ± 0.2%)
Methods
received 150-minute intraduodenal infusions of 0, 500, or 1000 mg calcium, each combined with Trp (load: 0.1 kcal/min, known to have submaximal energy-intake suppressant effects) from t = 75-150 minutes, on 3 separate occasions, in a randomized, double-blind, cross-over order
Blinding
Double-blind
Duration
150-minute

Context

In males of normal weight, intraduodenal administration of calcium enhances the effects of the amino acid L-tryptophan (Trp) to suppress energy intake, associated with greater stimulation of cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), and peptide tyrosine-tyrosine (PYY) secretion (key mechanisms underlying the regulation of pyloric motility and gastric emptying) but not gastrin or glucose-dependent insulinotropic polypeptide (GIP).

Objective

Given the implications for the management of obesity, the current study evaluated the effects of calcium, when administered alone and in combination with Trp, on gut hormone secretion, antropyloroduodenal motility, and energy intake in males with obesity.

Methods

Fifteen males with obesity and without type 2 diabetes (mean ± SD; age: 27 ± 8 years; body mass index: 30 ± 2 kg/m2; hemoglobin A1c: 5.3 ± 0.2%), received 150-minute intraduodenal infusions of 0, 500, or 1000 mg calcium, each combined with Trp (load: 0.1 kcal/min, known to have submaximal energy-intake suppressant effects) from t = 75-150 minutes, on 3 separate occasions, in a randomized, double-blind, cross-over order. Plasma concentrations of gastrin, CCK, GIP, GLP-1, PYY, and pyloric pressures were measured during the infusions. Immediately postinfusion (t = 150-180 minutes), energy intake at a standardized buffet-style lunch was quantified.

Results

Calcium, in a dose of 1000 mg, stimulated GLP-1, PYY, and pyloric pressures alone (all P < .05) and enhanced the effects of Trp to stimulate CCK, GLP-1, and PYY (all P < .05), associated with greater suppression of energy intake (P = .01). Energy intake (R = -0.64; P = .001) was inversely related to the dose of calcium, while plasma concentrations of CCK (R = 0.44; P = .05), GLP-1 (R = 0.60; P = .01), and PYY (R = 0.83; P = .01) were directly related.

Conclusion

Intraduodenal calcium enhances the effect of intraduodenal Trp to stimulate CCK, GLP-1, and PYY and suppress energy intake in males with obesity.

Research Insights

  • Calcium→Reduced Energy Intake

    Calcium, in a dose of 1000 mg, stimulated GLP-1, PYY, and pyloric pressures alone (all P < .05) and enhanced the effects of Trp to stimulate CCK, GLP-1, and PYY (all P < .05), associated with greater suppression of energy intake (P = .01).

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    500 mg
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