Sartorio A, Agosti F, Resnik M, Lafortuna C L
Laboratory for Experimental Endocrinological Research (LSRE), Italian Institute for Auxology, IRCCS, Milan, Italy.
J Endocrinol Invest. 2003 Mar;26(3):250-6. doi: 10.1007/BF03345165.
The effects of short-term (3 weeks) integrated body weight reduction (BWR) program (including energy-restricted diet, aerobic and strength exercise (5 days/week), nutritional education and psychological counseling) on plasma leptin levels and body composition were investigated in 54 morbidly obese patients (38 females/16 males; mean BMI +/- SE: 41.8 +/- 0.1 kg/m2, range 35-58 kg/m2; mean age: 29.8 +/- 1.0 yr, age range: 18-46 yr). The BWR program induced a significant (p < 0.001) weight loss (BMI reduction: -4.8%) and a significant modification in body composition, consisting in a fat mass (FM) decrease (-7.0 +/- 0.4%, p < 0.001) with a concomitant fat-free (FFM) mass increase (1.8 +/- 0.3%, p < 0.001). On average, plasma leptin levels decreased significantly both in males (from 19.4 +/- 2.6 ng/ml to 11.6 +/- 1.3 ng/ml, p < 0.001) and in females (from 41.1 +/- 3.6 ng/ml to 29.9 +/- 3.0 ng/ml, p < 0.001). Both before and after weight loss, leptin levels were positively correlated (p < 0.001) with BMI and percent fat mass (FM) values. Weight changes after the BWR program were negatively correlated with baseline leptin concentrations both in absolute terms and expressed per unit FM. In conclusion, a short-term diet plus aerobic/strength training effectively induces body composition changes and reduces plasma leptin levels. Body FM reduction appears to be not the unique determinant of leptin levels regulation and the degree of leptin over-expression may negatively affect weight loss in morbidly obese patients.
在54例病态肥胖患者（38例女性/16例男性；平均体重指数±标准误：41.8±0.1kg/m²，范围35 - 58kg/m²；平均年龄：29.8±1.0岁，年龄范围：18 - 46岁）中，研究了短期（3周）综合体重减轻（BWR）计划（包括能量限制饮食、有氧运动和力量训练（每周5天）、营养教育和心理咨询）对血浆瘦素水平和身体成分的影响。BWR计划导致显著的（p < 0.001）体重减轻（体重指数降低：-4.8%）和身体成分的显著改变，包括脂肪量（FM）减少（-7.0±0.4%，p < 0.001），同时无脂肪（FFM）量增加（1.8±0.3%，p < 0.001）。平均而言，男性（从19.4±2.6ng/ml降至11.6±1.3ng/ml，p < 0.001）和女性（从41.1±3.6ng/ml降至29.9±3.0ng/ml，p < 0.001）的血浆瘦素水平均显著降低。在体重减轻前后，瘦素水平均与体重指数和脂肪量（FM）百分比值呈正相关（p < 0.001）。BWR计划后的体重变化与基线瘦素浓度在绝对值和每单位FM方面均呈负相关。总之，短期饮食加有氧运动/力量训练可有效诱导身体成分变化并降低血浆瘦素水平。身体FM的减少似乎不是瘦素水平调节的唯一决定因素，瘦素过度表达的程度可能对病态肥胖患者的体重减轻产生负面影响。
