| Background:Overweight and Obesity are a major global health problem with increasing prevalence.They are defined as abnormal or excessive fat accumulation that may affect on humman. The main fundamental reason is the energy imbalance between intake of calories and burn calories. Body mass index (BMI) is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2) which is usually used for the classification of overweight and obesity in adults.With the increase of body mass index, the risk of noncommunicable diseases such as cardiovascular disease (including heart disease and stroke), diabetes, musculoskeletal disorders and some cancers is increased. However, the relationship between eating behavior of human beings and the pathogenesis of overweight and obesity are seldom reported.Ghrelin as a kind of feeding regulation hormone, mainly produced in the mucosa of gastric endocrine cells, is a polypeptide of 28 amino acids. The dysfunction between the feeding and energy control center which is located in the hypothalamus and the ghrelin is one of the important causes of overweight and obesity. It has become a new research focus in the field of obesity. It has been found that plasma ghrelin levels in adult obesity population is much lower than that in the normal control group or underweight, indicating that obesity may induce human central ghrelin resistance. In overweight people, ghrelin and eating behavior have positive correlation, according with the results of normal weight group and animal experiment. But the relationship between eating behavior in obese people and plasma concentrations of ghrelin has not been reported in China, so we studied this aspect. his with normal body weight adults before and the results of animal experiments.But obese people eating behavior and the relationship between plasma ghrelin concentrations research has not been reported in home, so we study the aspects. As eating behavior plays an important role in the regulation of energy, different eating styles may be relevant to health related factors such as weight gain and obesity, there are several types of eating behavior has been identified in the field of eating behavior research including restraint eating, external eating, uncontrolled eating and emotional eating.The prevalence and development of overweight and obesity are affected by the interaction of many factors such as heredity, environment and behavior, the study on the relationship between external eating behavior and internal regulation of feeding related hormones, are reported rarely in the literature both in China and abroad.Therefore, we analyze on the relationships between eating behaviors of obese people and plasma concentrations of ghrelin to explore the role of it in the pathogenesis of obesity.Aim:To test the Chinese version of the Three factor Eating Questionnaire R21 (TFEQ-R21) in the application of undergraduates, and to evaluate its reliability and validity when it is necessary to modify the structure of the questionnaire.Then to investigate the relationship between eating behavior of obese people and plasma concentration of ghrelin with its role in the pathogenesis of obesity.Methods:This study is divided into two parts:in the first part,436 undergraduates completed the Chinese version of TFEQ-R21. Then the data were randomly divided into sample 1 (N=196) and sample 2 (N=240).Sample 1 was used to do exploratory factor analysis (EFA) while sample 2 was used to do confirmatory factor analysis (CFA).56 of them were retested 12 weeks later; In the second part,117 overweight/obese subjects and 40 healthy control subjects who participated in health examination at Yangzhou Hospital of Traditional Chinese Medicine medical center from April 2014 to July 2015 were performed epidemiological survey. The revised Chinese version of the Three Factor Eating Questionnaire-R21 (TFEQ-R18V3) was used for the measurement of eating behavior.The level of fasting plasma Ghrelin was detected by enzyme linked immunosorbent assay(ELISA) in 157 participants.Variance analysis, chi square test, regression analysis and curve fitting were used for statistical treatment.Results:Part 1:After four times of exploratory factor analysis, the modified version TFEQ-R18V3 was formed. Taking the characteristic value > 1,3 common factors i.e.Uncontrolled eating, Cognitive restraint and Emotional eating were extracted, which explained 58.9% of the total variance. Confirmatory factor analysis showed that the three factor model has good fitting index (GFI=0.872, AGFI=0.834, IFI=0.903, CFI=0.902, RMSEA=0.076, AIC=393.139). The internal consistency reliability of the Cronbach’ α coefficient of TFEQ-R18V3 was between 0.76 and 0.89, and the retest reliability coefficient was above 0.7, it also has a good criterion validity. Part 2:The concentration of fasting plasma ghrelin did not differ significantly between normal weight group and overweight (P> 0.05),while it had significant difference between obese people and both normal weight group and overweight (P< 0.001); A nonlinear relationship between ghrelin and emotional eating was observed.The level of fasting plasma ghrelin was not associated with uncontrolled eating, cognitive eating and external eating (P>0.05);The score of emotional eating decreased with the level of fasting plasma ghrelin up to the turning point (962.286pg/ml)(adjustedβ-0.017,95%CI:-0.032,-0.002; P<0.05). When the ghrelin level exceeded 962.286pg/ml, the score of emotional eating will increase with the increase of the concentration of ghrelin(adjusted β 0.035,95%CI:0.012,0.057; P<0.01).Conclusion:The modified version TFEQ-R18V3 has good reliability and validity in undergraduates which can be used as an effective tool for the measurement of eating behavior; Emotional eating has a significant nonlinear relationship with plasma ghrelin, and it is more likely to be affected by negative emotions in obese people compared with normal weight group. |
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