Low human peptide YY (PYY) plasma levels were recently reported to justify PYY replacement
therapy in human obesity (N Engl J Med 2003 349(10) 941–948). The pharmacological
potential of PYY 3–36 (mainly circulating form of PYY) is discussed controversially,
as the influence of PYY in the regulation of energy balance remains unclear. Methods: PYY plasma levels of 51 lean (BMI: 22.7±0.5kg/m2), 20 anorectic (BMI: 15.2±0.2), 53 obese (BMI: 33.2±0.7) and 13 morbidly obese (BMI:
43.2±2.1) subjects were investigated. Additionally PYY levels from 13 obese patients
before and after weight loss (-4.2%) and 20 anorectic patients before and after weight
gain (+14%) were analyzed. PYY plasma levels were measured using a commercially available
PYY EIA (Diagnostic Systems Laboratories, USA). Results: PYY levels in anorectic patients (92±8 pg/ml, p≤0.01) were higher than those of
lean (43±4 pg/ml), obese (41±6 pg/ml) or morbidly obese (47±16 pg/ml) individuals.
Weight gain in anorectic patients did not change fasting plasma PYY levels. PYY levels
of obese patients decreased after weight loss (P≤0.001). Conclusion: Our findings from a large population of obese and morbidly obese patients indicate
that there is no obvious PYY deficiency in human obesity. Therefore, a PYY replacement
therapy does not seem to be an option for the treatment of obesity. In contrast, circulating
PYY levels in humans might play a role in anorexia nervosa. However, until reliable
methods for the specific quantification of PYY1–36 and PYY3–36 become available, findings
regarding the functional role of endogenous PYY must be interpreted with caution.