高危肥胖受试者体重减轻和体重维持后的脂蛋白反应。

Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects.

作者信息

Ditschuneit H H, Frier H I, Flechtner-Mors M

机构信息

Department of Medicine, University Ulm, Germany.

出版信息

Eur J Clin Nutr. 2002 Mar;56(3):264-70. doi: 10.1038/sj.ejcn.1601375.

DOI:10.1038/sj.ejcn.1601375

PMID:11960302

Abstract

OBJECTIVE

To examine changes in plasma lipids and lipoproteins after 51 months of reduced energy intake and sustained weight loss.

METHODS

One-hundred patients were randomized to one of two dietary interventions for 3 months (weight loss period). Groups A and B received an energy-restricted diet plan of 5.2-6.3 MJ/day but group B was further instructed to replace two of three meals with a nutrient-fortified liquid meal replacement (MR). Upon completion of the weight loss period, all patients were given the same instructions regarding energy intake and were advised to use one MR daily. Body weight and 7 day food diaries were measured monthly or bimonthly and blood lipids at baseline, 3, 9 and 51 months.

RESULTS

Of the original 100 patients 75 had completed 4 y. Of those 75, 73 had complete lipid records. Baseline body weights of Groups A and B were 90.7+/-14.0 and 91.6+/-9.8 kg, respectively. The percentage change in total cholesterol (%DeltaTC) decreased in a linear fashion with increasing weight loss, when all data was combined, but did not approach statistical significance (P< or =0.26, r=0.02). Further regression analysis found a significant negative linear relationship (P< or =0.0001, r=0.69) between initial total cholesterol (TC) concentrations and %DeltaTC. Hence, data from 27 of the 73 completers who exhibited an elevated serum total cholesterol (> or =6.2 mmol/l) were isolated and analyzed further. Baseline TC was 6.75+/-0.64, 5.85+/-0.63 at 9 months (P<0.05) and 5.76+/-0.52 mmol/l at 51 months (P<0.05). Similar values for VLDL-cholesterol were 1.33+/-0.80, 0.74+/-0.24 and 0.66+/-0.21 mmol/l by 51 months (P<0.05). Weight decreased by 5.2+/-5.1, 7.6+/-4.9 and 6.7+/-4.6% at 3, 9 and 51 months, respectively.

CONCLUSION

Continuous energy restriction associated with a clinically meaningful weight loss significantly improved the lipid profile of high-risk patients. Similar weight and diet changes occurring in patients with normal plasma cholesterol were either increased or without affect.

摘要

目的

研究能量摄入减少及持续体重减轻51个月后血浆脂质和脂蛋白的变化。

方法

100名患者被随机分为两种饮食干预组，为期3个月（体重减轻期）。A组和B组接受每天5.2 - 6.3兆焦耳的能量限制饮食计划，但B组还被进一步指导用营养强化液体代餐（MR）替代三餐中的两餐。体重减轻期结束后，所有患者都收到了关于能量摄入的相同指导，并被建议每天使用一份MR。每月或每两个月测量体重和7天食物日记，并在基线、3个月、9个月和51个月时测量血脂。

结果

最初的100名患者中有75名完成了4年研究。在这75名患者中，73名有完整的血脂记录。A组和B组的基线体重分别为90.7±14.0千克和91.6±9.8千克。当合并所有数据时，总胆固醇的百分比变化（%ΔTC）随着体重减轻的增加呈线性下降，但未达到统计学显著性（P≤0.26，r = 0.02）。进一步的回归分析发现初始总胆固醇（TC）浓度与%ΔTC之间存在显著的负线性关系（P≤0.0001，r = 0.69）。因此，从73名血清总胆固醇升高（≥6.2毫摩尔/升）的完成者中选取27名的数据进行进一步分析。基线TC为6.75±0.64，9个月时为5.85±0.63（P<0.05），51个月时为5.76±0.52毫摩尔/升（P<0.05）。极低密度脂蛋白胆固醇的类似值在51个月时分别为1.33±0.80、0.74±0.24和0.66±0.21毫摩尔/升（P<0.05）。在3个月、9个月和51个月时体重分别下降了5.2±5.1%、7.6±4.9%和6.7±4.6%。