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Meta-Analysis
. 2020 Jul;32(7):1233-1244.
doi: 10.1007/s40520-019-01292-6. Epub 2019 Aug 20.

Differences in circulating appetite-related hormone concentrations between younger and older adults: a systematic review and meta-analysis

Kelsie Olivia Johnson  1 , Oliver Michael Shannon  1   2 , Jamie Matu  3   4 , Adrian Holliday  1 , Theocharis Ispoglou  1 , Kevin Deighton  5   6
Affiliations
Meta-Analysis

Differences in circulating appetite-related hormone concentrations between younger and older adults: a systematic review and meta-analysis

Kelsie Olivia Johnson et al. Aging Clin Exp Res. 2020 Jul.

Abstract

Ageing is associated with reduced appetite and energy intakes. However, the mechanisms underlying this phenomenon are not fully understood. This systematic review and meta-analysis quantified differences in circulating concentrations of appetite-related hormones between healthy older and younger adults. Six databases were searched through 12th June 2018 for studies that compared appetite-related hormone concentrations between older and younger adults. Data were pooled using random-effects meta-analysis and are presented as standardised mean difference (Hedges' g) with 95% confidence intervals (95% CI). Thirty-five studies were included involving 710 older adults (mean ± SD; age: 73 ± 5 years) and 713 younger adults (age: 28 ± 7 years). Compared with younger adults, older adults exhibited higher fasted and postprandial concentrations of the anorectic hormones cholecystokinin (Fasted: SMD 0.41 (95% CI 0.24, 0.57); p < 0.001. Postprandial: SMD 0.41 (0.20, 0.62); p < 0.001), leptin [Fasted: SMD 1.23 (0.15, 2.30); p = 0.025. Postprandial: SMD 0.62 (0.23, 1.01); p = 0.002] and insulin [Fasted: SMD 0.24 (- 0.02, 0.50); p = 0.073. Postprandial: SMD 0.16 (0.01, 0.32); p = 0.043]. Higher postprandial concentrations of peptide-YY were also observed in older adults compared with younger adults [SMD 0.31 (- 0.03, 0.65); p = 0.075]. Compared with younger adults, older adults had lower energy intakes [SMD - 0.98 (- 1.74, - 0.22); p = 0.011], and lower hunger perceptions in the fasted [SMD - 1.00 (- 1.54, - 0.46); p < 0.001] and postprandial states [SMD - 0.31, (- 0.64, 0.02); p = 0.064]. Higher circulating concentrations of insulin, leptin, cholecystokinin and peptide-YY accord with reduced appetite and energy intakes in healthy older adults. Interventions to reduce circulating levels of these hormones may be beneficial for combatting the anorexia of ageing.

Keywords: Anorexia of ageing; Appetite; Energy intake; Hunger.

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Conflict of interest statement

The authors confirm no conflict of interest.

Figures

Fig. 1
Fig. 1
Forest plot of standardised mean differences (means ± 95% confidence intervals [CIs] for studies evaluating the differences in fasted CCK concentrations (a) and postprandial CCK concentrations (b) in older versus younger adults. The size of each square represents the relative weight of each comparison. The diamond represents the SMD (mean ± 95% CI) for the model
Fig. 2
Fig. 2
Forest plot of standardised mean differences (means ± 95% confidence intervals [CIs] for studies evaluating the differences in fasted leptin concentrations (a) and postprandial leptin concentrations (b) in older versus younger adults. The size of each square represents the relative weight of each comparison. The diamond represents the SMD (mean ± 95% CI) for the model
Fig. 3
Fig. 3
Forest plot of standardised mean differences (means ± 95% confidence intervals [CIs] for studies evaluating the differences in fasted insulin concentrations (a) and postprandial insulin concentrations (b) in older versus younger adults. The size of each square represents the relative weight of each comparison. The diamond represents the SMD (mean ± 95% CI) for the model
Fig. 4
Fig. 4
Forest plot of standardised mean differences (means ± 95% confidence intervals [CIs] for studies evaluating the differences in fasted PYY concentrations (a) and postprandial PYY concentrations (b) in older versus younger adults. The size of each square represents the relative weight of each comparison. The diamond represents the SMD (mean ± 95% CI) for the model
Fig. 5
Fig. 5
Forest plot of standardised mean differences (means ± 95% confidence intervals [CIs] for studies evaluating the differences in energy intake in older versus younger adults. The size of each square represents the relative weight of each comparison. The diamond represents the SMD (mean ± 95% CI) for the model
Fig. 6
Fig. 6
Forest plot of standardised mean differences (means ± 95% confidence intervals [CIs] for studies evaluating the differences in fasted hunger (a) and postprandial hunger (b) in older versus younger adults. The size of each square represents the relative weight of each comparison. The diamond represents the SMD (mean ± 95% CI) for the model
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