生活方式改变对肥胖患者脂肪细胞因子水平的影响。

Effects of lifestyle modification on adipocytokine levels in obese patients.

作者信息

De Luis D A, Aller R, Izaola O, Gonzalez Sagrado M, Conde R, Perez Castrillon J L

机构信息

Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega RD056/0013, University of Valladolid, Valladolid, Spain.

出版信息

Eur Rev Med Pharmacol Sci. 2008 Jan-Feb;12(1):33-9.

PMID:18401970

Abstract

OBJECTIVE

Adipose tissue is considered an active secretory organ of adipocytokines. The principal aim of our study was to examine the changes in adipocytokines levels after weigth reduction in obese patients.

MATERIALS AND METHODS

A population of 126 obese (body mass index > 30) non-diabetic outpatients was analyzed in a prospective way. Before and after three months of a lifestyle modification program, an indirect calorimetry, a tetrapolar electrical bioimpedance, blood pressure, a serial assessment of nutritional intake with 3 days written food records and a series of biochemical analyses were performed. The lifestyle modification program consisted of a daily hypocaloric diet (1520 kcal: 52% of carbohydrates, 25% of lipids and 23% of proteins). The exercise program consisted of an aerobic exercise for at least 3 times per week (60 minutes each).

RESULTS

The mean age was 45.6 +/- 16.9 years and the mean BMI 34.5 +/- 5.2, with 33 males (26.2%) and 93 females (73.8%). A total of 88 patients completed the follow up during 3 months, with a percentage of weight loss of 3.1%. Seventy two patients lost weight after treatment (responders) with an average age of 45.4 +/- 16.8 years and a percentage of weight loss of 4.2%. Sixteen patients did not respond (no-responders), with an increase in weight (88.9 +/- 10.5 vs 88.7 +/- 10.9 kg: p < 0.05) and BMI (34.7 +/- 5.4 vs 35.5 +/- 5.5 kg: p < 0.05). The average age (45.9 +/- 15.9 years) of this group was similar than that of responders. In responders (weight loss), BMI, weight, fat mass, glucose, total cholesterol, LDL cholesterol and systolic blood pressure decreased and VO2 increased. After treatment, no statistical differences were detected in energy intake: carbohydrate, fat, and protein. Exercise improved after treatment in responder group. Only serum leptin levels had a significant decrease in responder group (12%). After treatment, no responder group has similar values of all adipokines, including leptin (81.3 +/- 70.6 vs. 76.1 +/- 43 ng/ml).

CONCLUSION

Three months of lifestyle modification significantly improved anthropometric and cardiovascular risk factors, regardless of their minimal decrease in energy intake and the weight loss. Additional studies will be need to clarify the contribution of lifestyle modification in changes of serum adipocytokine levels.

摘要

目的

脂肪组织被认为是脂肪细胞因子的一个活跃分泌器官。我们研究的主要目的是检测肥胖患者体重减轻后脂肪细胞因子水平的变化。

材料与方法

前瞻性分析了126名肥胖（体重指数>30）的非糖尿病门诊患者。在进行为期三个月的生活方式改变计划之前和之后，进行了间接测热法、四极生物电阻抗测量、血压测量、通过3天的书面饮食记录进行的营养摄入系列评估以及一系列生化分析。生活方式改变计划包括每日低热量饮食（1520千卡：52%为碳水化合物，25%为脂质，23%为蛋白质）。运动计划包括每周至少进行3次有氧运动（每次60分钟）。

结果

平均年龄为45.6±16.9岁，平均体重指数为34.5±5.2，其中男性33名（26.2%），女性93名（73.8%）。共有88名患者在3个月内完成了随访，体重减轻百分比为3.1%。72名患者治疗后体重减轻（有反应者），平均年龄为45.4±16.8岁，体重减轻百分比为4.2%。16名患者无反应（无反应者），体重增加（88.9±10.5 vs 88.7±10.9千克：p<0.05），体重指数增加（34.7±5.4 vs 35.5±5.5千克：p<0.05）。该组的平均年龄（45.9±15.9岁）与有反应者相似。在有反应者（体重减轻）中，体重指数、体重、脂肪量、血糖、总胆固醇、低密度脂蛋白胆固醇和收缩压降低，而耗氧量增加。治疗后，能量摄入（碳水化合物、脂肪和蛋白质）方面未检测到统计学差异。有反应者组治疗后运动情况有所改善。只有有反应者组的血清瘦素水平显著降低（12%）。治疗后，无反应者组的所有脂肪细胞因子，包括瘦素，均有相似的值（81.3±70.6 vs. 76.1±43纳克/毫升）。