Laaksonen D E, Kainulainen S, Rissanen A, Niskanen L
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Nutr Metab Cardiovasc Dis. 2003 Dec;13(6):349-56. doi: 10.1016/s0939-4753(03)80003-0.
Little is known about the association between abdominal obesity and insulin sensitivity during rapid weight loss. We assessed the role of visceral and subcutaneous fat as determinants of insulin sensitivity during rapid weight loss in obese persons with the metabolic syndrome.
Twenty abdominally obese individuals [11 women and 9 men, body mass index (BMI) 35.8+/-3.5 kg/m2] with the metabolic syndrome underwent a very-low-calorie diet (VLCD) for nine weeks. At baseline, the computed tomography (CT) measured area of total (r=-0.50, p=0.033) and visceral fat tissue (r=-0.48, p=0.043), but not that of subcutaneous fat tissue (r=-0.34, p=0.17), correlated with insulin sensitivity as assessed by the quantitative insulin sensitivity check index after adjusting for sex and age. The 18 subjects who completed the study lost 14.8 kg during the VLCD. Total, visceral and subcutaneous abdominal fat tissue decreased by 22%, 29% and 17%, respectively. The decrease in total (r=-0.51, p=0.035) and subcutaneous abdominal fat (r=-0.57, p=0.017), but not visceral fat (r=0.11, p=0.68), correlated with the increase in insulin sensitivity. Waist circumference did not offer any additional information concerning abdominal fat distribution or insulin sensitivity compared with that provided by BMI at baseline or after weight loss. The waist/hip ratio was not associated with the CT measures of abdominal fat distribution or insulin sensitivity.
Total abdominal fat may be more important than its compartmentalisation in abdominally obese individuals with the metabolic syndrome. In this subgroup of individuals with obesity, the measurement of waist circumference and the waist/hip ratio offered little additional information over that provided by BMI at baseline or after weight loss.
关于快速减重期间腹部肥胖与胰岛素敏感性之间的关联，目前所知甚少。我们评估了内脏脂肪和皮下脂肪在患有代谢综合征的肥胖者快速减重期间作为胰岛素敏感性决定因素的作用。
20名患有代谢综合征的腹部肥胖个体（11名女性和9名男性，体重指数[BMI]为35.8±3.5kg/m²）接受了为期9周的极低热量饮食（VLCD）。在基线时，经计算机断层扫描（CT）测量，调整性别和年龄后，总脂肪组织面积（r = -0.50，p = 0.033）和内脏脂肪组织面积（r = -0.48，p = 0.043）与通过定量胰岛素敏感性检查指数评估的胰岛素敏感性相关，而皮下脂肪组织面积（r = -0.34，p = 0.17）与之无关。完成研究的18名受试者在VLCD期间体重减轻了14.8kg。腹部总脂肪、内脏脂肪和皮下脂肪组织分别减少了22%、29%和17%。总腹部脂肪（r = -0.51，p = 0.035）和皮下腹部脂肪（r = -0.57，p = 0.017）的减少与胰岛素敏感性的增加相关，而内脏脂肪减少（r = 0.11，p = 0.68）与之无关。与基线或减重后的BMI相比，腰围在腹部脂肪分布或胰岛素敏感性方面未提供任何额外信息。腰臀比与腹部脂肪分布的CT测量值或胰岛素敏感性无关。
在患有代谢综合征的腹部肥胖个体中，腹部总脂肪可能比其分区更为重要。在这一肥胖亚组个体中，腰围和腰臀比的测量在基线或减重后相比BMI并未提供更多额外信息。
