Chaston T B, Dixon J B
Australian Centre for Obesity Research and Education, Monash University, Melbourne, Victoria, Australia.
Int J Obes (Lond). 2008 Apr;32(4):619-28. doi: 10.1038/sj.ijo.0803761. Epub 2008 Jan 8.
Visceral adipose tissue (VAT) is associated with greater obesity-related metabolic disturbance. Many studies have reported preferential loss of VAT with weight loss.
This systematic review looks for factors associated with preferential loss of VAT relative to subcutaneous abdominal fat (SAT) during weight loss.
Medline and Embase were searched for imaging-based measurements of VAT and subcutaneous abdominal adipose tissue (SAT) before and after weight loss interventions. We examine for factors that influences the percentage change in VAT versus SAT (%deltaV/%deltaS) with weight loss. Linear regression analyses were performed on the complete data set and on subgroups of studies. Factors examined included percentage weight loss, degree of caloric restriction, exercise, initial body mass index (BMI), gender, time of follow-up and baseline VAT/SAT.
There were 61 studies with a total of 98 cohort time points extracted. Percentage weight loss was the only variable that influenced %deltaV/%deltaS (r=-0.29, P=0.005). Modest weight loss generated preferential loss of VAT, but with greater weight loss this effect was attenuated. The method of weight loss was not an influence with one exception. Very-low-calorie diets (VLCDs) provided exceptional short-term (<4 weeks) preferential VAT loss. But this effect was lost by 12-14 weeks.
Visceral adipose tissue is lost preferentially with modest weight loss, but the effect is attenuated with greater weight loss. Acute caloric restriction, using VLCD, produces early preferential loss of VAT. These observations may help to explain the metabolic benefits of modest weight loss.
内脏脂肪组织（VAT）与更严重的肥胖相关代谢紊乱有关。许多研究报告称，减肥过程中VAT会优先减少。
本系统评价旨在寻找减肥期间相对于腹部皮下脂肪（SAT），VAT优先减少的相关因素。
检索Medline和Embase数据库，查找减肥干预前后基于影像学测量的VAT和腹部皮下脂肪组织（SAT）数据。我们研究影响减肥过程中VAT与SAT变化百分比（%δV/%δS）的因素。对完整数据集和各研究亚组进行线性回归分析。所研究的因素包括体重减轻百分比、热量限制程度、运动、初始体重指数（BMI）、性别、随访时间和基线VAT/SAT。
共纳入61项研究，提取了98个队列时间点的数据。体重减轻百分比是唯一影响%δV/%δS的变量（r = -0.29，P = 0.005）。适度减肥会使VAT优先减少，但随着减肥幅度增大，这种效果会减弱。除了一个例外，减肥方法并无影响。极低热量饮食（VLCD）在短期内（<4周）能使VAT优先减少，但这种效果在12 - 14周时消失。
适度减肥时内脏脂肪组织会优先减少，但随着减肥幅度增大，这种效果会减弱。采用VLCD进行急性热量限制可使VAT早期优先减少。这些观察结果可能有助于解释适度减肥的代谢益处。
