Davì Giovanni, Guagnano Maria Teresa, Ciabattoni Giovanni, Basili Stefania, Falco Angela, Marinopiccoli Marina, Nutini Michele, Sensi Sergio, Patrono Carlo
Center of Excellence on Aging, G. D'Annunzio University Schools of Medicine and Pharmacy, Chieti, Italy.
JAMA. 2002;288(16):2008-14. doi: 10.1001/jama.288.16.2008.
Obesity, in particular abdominal adiposity, is associated with increased cardiovascular morbidity and mortality through mechanisms possibly linking the metabolic disorder to platelet and vascular abnormalities.
To investigate the clinical and biochemical determinants of lipid peroxidation and platelet activation in obese women.
DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional comparison, conducted between September 1999 and September 2001, of urinary 8-iso prostaglandin F(2alpha) (8-iso PGF(2alpha)) and 11-dehydrothromboxane B2 (11-dehyhdro-TxB2) excretion levels in 93 women: 44 with a body mass index (BMI) higher than 28 and a waist-to-hip ratio (WHR) of 0.86 or higher, android obesity; 25 with a BMI higher than 28 and a WHR lower than 0.86, gynoid obesity; and 24 nonobese women with a BMI lower than 25. An additional study was conducted to determine the short-term effects of weight loss in 20 of the 44 women with android obesity.
During a 12-week period, 20 women with android obesity followed a weight loss program to reduce caloric intake to about 1200 kcal/d.
Plasma C-reactive protein, insulin and leptin levels, and urinary 8-iso PGF(2alpha) (marker of in vivo lipid peroxidation) and 11-dehyhdro-TxB2 (marker of in vivo platelet activation) excretion. Weight loss was defined as successful when the initial body weight decreased by at least 5 kg after a 12-week period of caloric restriction.
Women with android obesity had higher levels of 8-iso PGF(2alpha )(median [interquartile range [IQR]] 523 [393-685] vs 187 [140-225] pg/mg creatinine) and 11-dehyhdro-TxB2 (median [IQR], 948 [729-1296] vs 215 [184-253] pg/mg creatinine) than nonobese women (P<.001). Both 8-iso PGF(2alpha)and 11-dehyhdro-TxB2 were higher in women with android obesity than women with gynoid obesity (P<.001). Based on multiple regression analysis, C-reactive protein levels and WHRs of 0.86 or higher predicted the rate of 8-iso PGF(2alpha) excretion independently of insulin and leptin levels. Of 20 women with android obesity, 11 achieved successful weight loss, which was associated with statistically significant reductions in C-reactive protein (median change, 23%; P<.05), 8-iso PGF(2alpha) (median change, 32%; P =.04) and 11-dehydro-TxB2 (median change, 54%; P =.005).
Android obesity is associated with enhanced lipid peroxidation and persistent platelet activation. These abnormalities are driven by inflammatory triggers related to the degree of abdominal adiposity and are, at least in part, reversible with a successful weight-loss program.
肥胖，尤其是腹部肥胖，通过可能将代谢紊乱与血小板和血管异常联系起来的机制，与心血管疾病发病率和死亡率增加相关。
研究肥胖女性体内脂质过氧化和血小板活化的临床及生化决定因素。
设计、地点和参与者：1999年9月至2001年9月间进行的横断面比较，检测了93名女性的尿8-异前列腺素F2α（8-iso PGF2α）和11-脱氢血栓素B2（11-dehyhdro-TxB2）排泄水平：44名体重指数（BMI）高于28且腰臀比（WHR）为0.86或更高的女性，为男性型肥胖；25名BMI高于28且WHR低于0.86的女性，为女性型肥胖；以及24名BMI低于25的非肥胖女性。另外还对44名男性型肥胖女性中的20名进行了一项研究，以确定体重减轻的短期影响。
在12周的时间里，20名男性型肥胖女性遵循一项减肥计划，将热量摄入减少至约1200千卡/天。
血浆C反应蛋白、胰岛素和瘦素水平，以及尿8-iso PGF2α（体内脂质过氧化标志物）和11-dehyhdro-TxB2（体内血小板活化标志物）排泄。当经过12周的热量限制后初始体重至少下降5千克时，体重减轻被定义为成功。
男性型肥胖女性的8-iso PGF2α水平（中位数[四分位间距[IQR]]523[393 - 685]对187[140 - 225]皮克/毫克肌酐）和11-dehyhdro-TxB2水平（中位数[IQR]，948[729 - 1296]对215[184 - 253]皮克/毫克肌酐）高于非肥胖女性（P<0.001）。男性型肥胖女性的8-iso PGF2α和11-dehyhdro-TxB2均高于女性型肥胖女性（P<0.001）。基于多元回归分析，C反应蛋白水平和WHR为0.86或更高可独立于胰岛素和瘦素水平预测8-iso PGF2α排泄率。在20名男性型肥胖女性中，11名实现了成功减重，这与C反应蛋白（中位数变化，23%；P<0.05）、8-iso PGF2α（中位数变化，32%；P = 0.
