Santosa S, Demonty I, Lichtenstein A H, Jones P J H
School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC, Canada.
Int J Obes (Lond). 2007 Jun;31(6):933-41. doi: 10.1038/sj.ijo.0803549. Epub 2007 Jan 30.
To determine how moderate weight loss protocol through diet and exercise may affect changes in body composition, to determine the effects of weight loss on cholesterol metabolism and to examine the relationship between cholesterol metabolism and changes in body composition.
Thirty-five otherwise healthy, hypercholesterolemic women completed a 24-week weight loss study. A 20% decrease in energy intake through diet and a 10% increase in energy expenditure by exercise were combined with motivational strategies to encourage weight loss. The diet was self-selected and comprised of 50-60% carbohydrates, 20% protein and <30% fat.
Participants lost an average of 11.7+/-2.5 kg (P<0.001). Whole body and regional losses in tissue mass occurred after weight loss. After weight loss, cholesterol fractional synthesis rate (FSR) decreased (P=0.003) 3.86+/-9.33%, whereas rates of cholesterol absorption and turnover did not change (3.31+/-19.4%, P=0.32 and -0.01+/-6.20%, P=0.75, respectively). Changes in cholesterol turnover were positively correlated (r=0.44, P=0.01) with changes in FSR. Reductions in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were predictive (beta=-5.04, r=0.38; P=0.03, and beta=-147, r=0.40; P=0.03, respectively) of increases in cholesterol turnover. Losses in skeletal muscle (SM) and upper-body SM predicted (beta=6.82, r=0.36; P=0.04 and beta=14.7, r=0.41; P=0.01, respectively) decreases in cholesterol absorption.
Decreases in cholesterol synthesis after moderate weight loss are not compensated for by changes in cholesterol absorption or turnover. Changes in regional body composition were associated with variations in cholesterol metabolism. Understanding how weight loss affects cholesterol metabolism will help identify more effective treatment routes for overweight individuals undergoing weight loss resulting in earlier and more intensive therapy for the associated dyslipidemia.
确定通过饮食和运动进行适度减重方案如何影响身体成分的变化，确定减重对胆固醇代谢的影响，并研究胆固醇代谢与身体成分变化之间的关系。
35名其他方面健康的高胆固醇血症女性完成了一项为期24周的减重研究。通过饮食使能量摄入减少20%，通过运动使能量消耗增加10%，并结合激励策略以促进减重。饮食为自选，碳水化合物占50 - 60%，蛋白质占20%，脂肪占<30%。
参与者平均减重11.7±2.5千克（P<0.001）。减重后全身及各部位组织质量均有减少。减重后，胆固醇分数合成率（FSR）下降（P = 0.003）3.86±9.33%，而胆固醇吸收率和周转率未发生变化（分别为3.31±19.4%，P = 0.32和 - 0.01±6.20%，P = 0.75）。胆固醇周转率的变化与FSR的变化呈正相关（r = 0.44，P = 0.01）。内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的减少可预测胆固醇周转率的增加（分别为β = - 5.04，r = 0.38；P = 0.03，以及β = - 147，r = 0.40；P = 0.03）。骨骼肌（SM）和上身SM的减少可预测胆固醇吸收率的降低（分别为β = 6.82，r = 0.36；P = 0.04以及β = 14.7，r = 0.41；P = 0.01）。
适度减重后胆固醇合成的减少并未因胆固醇吸收或周转率的变化而得到补偿。身体局部成分的变化与胆固醇代谢的改变相关。了解减重如何影响胆固醇代谢将有助于为正在减重的超重个体确定更有效的治疗途径，从而对相关血脂异常进行更早、更强化的治疗。
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