Franssila-Kallunki A, Rissanen A, Ekstrand A, Ollus A, Groop L
Department of Psychiatry, Helsinki University Hospital, Finland.
Am J Clin Nutr. 1992 Feb;55(2):356-61. doi: 10.1093/ajcn/55.2.356.
To evaluate the effect of weight loss on substrate oxidation, energy expenditure, and insulin sensitivity we studied 12 obese subjects (body mass index 33.4 +/- 1.1) before and after 6 wk of a very-low-calorie diet (VLCD) with euglycemic insulin clamp in combination with indirect calorimetry. Body weight decreased from 105.3 +/- 4.6 to 94.1 +/- 4.0 kg (P less than 0.001) and fat mass from 47.2 +/- 3.6 to 37.7 +/- 3.0 kg (P less than 0.001). Total glucose disposal during insulin clamp increased from 30.4 +/- 4.3 to 38.4 +/- 4.4 mumol.kg lean body mass (LBM)-1.min-1 (P less than 0.05), insulin-stimulated glucose oxidation from 14.3 +/- 4.6 to 19.1 +/- 1.4 mumol.kg LBM-1.min-1 (P less than 0.05), and non-oxidative glucose metabolism from 16.0 +/- 3.8 to 19.3 +/- 3.6 mumol.kg LBM-1.min-1 (NS). Lipid oxidation decreased in the basal state (P less than 0.05) and during the insulin clamp (P less than 0.01). The basal rate of energy expenditure decreased from 99.1 +/- 4.6 to 88.5 +/- 2.7 kJ.kg LBM-1.min-1 (P less than 0.05) after weight reduction. A reduction in fat mass achieved by VLCD is associated with reduced lipid oxidation and, because of substrate competition, enhanced glucose oxidation. The physiological consequence is improved insulin sensitivity.
为评估体重减轻对底物氧化、能量消耗及胰岛素敏感性的影响，我们对12名肥胖受试者（体重指数33.4±1.1）进行了研究，在极低热量饮食（VLCD）6周前后，采用正常血糖胰岛素钳夹技术并结合间接测热法。体重从105.3±4.6千克降至94.1±4.0千克（P<0.001），脂肪量从47.2±3.6千克降至37.7±3.0千克（P<0.001）。胰岛素钳夹期间总的葡萄糖处置量从30.4±4.3微摩尔·千克去脂体重（LBM）-1·分钟-1增至38.4±4.4微摩尔·千克LBM-1·分钟-1（P<0.05），胰岛素刺激的葡萄糖氧化从14.3±4.6微摩尔·千克LBM-1·分钟-1增至19.1±1.4微摩尔·千克LBM-1·分钟-1（P<0.05），非氧化葡萄糖代谢从16.0±3.8微摩尔·千克LBM-1·分钟-1增至19.3±3.6微摩尔·千克LBM-1·分钟-1（无显著差异）。基础状态下（P<0.05）及胰岛素钳夹期间（P<0.01）脂质氧化减少。体重减轻后，基础能量消耗率从99.1±4.6千焦·千克LBM-1·分钟-1降至88.5±2.7千焦·千克LBM-1·分钟-1（P<0.05）。极低热量饮食导致的脂肪量减少与脂质氧化减少有关，并且由于底物竞争，葡萄糖氧化增强。其生理结果是胰岛素敏感性提高。
