Goldberg Y, Boaz M, Matas Z, Goldberg I, Shargorodsky M
Department of Medicine, Wolfson Medical Center and Tel Aviv University, Tel Aviv, Israel.
Clin Nutr. 2009 Feb;28(1):21-5. doi: 10.1016/j.clnu.2008.10.001. Epub 2008 Nov 18.
BACKGROUND & AIMS: Obesity is associated with increased arterial stiffness, an early marker of vascular wall damage. However, data on the long-term vascular impact of intentional weight loss are limited. The aim of the present study was to evaluate the effect of weight loss induced by nutritional and exercise intervention on arterial compliance, metabolic and inflammatory parameters in obese patients who participated in a weight reduction program.
In an open label, prospective study, 37 obese subjects attended a 24 weeks nutritional and exercise interventional program. Arterial elasticity was evaluated using pulse-wave contour analysis (HDI CR-2000, Eagan, Minnesota) at baseline and at the end of the study. Fasting glucose, HbA1C, insulin, lipid profile, hs-CRP, fibrinogen were measured at baseline and after 6 months. Insulin resistance was assessed by homeostasis model assessment-insulin resistance (HOMA-IR).
BMI decreased from 36.1 +/- 7.4 kg/m(2) at baseline to 32.8 +/- 7.4 kg/m(2) after 6 months (p<0.0001). Large artery elasticity index (LAEI) increased from 12.1 +/- 4.1 to 15.8 +/- 4.7 ml/mmHg x 10 during the study (p<0.0001). Small artery elasticity index (SAEI) increased from 4.4+/-2.4 to 5.5 +/- 2.7 ml/mmHg x 100 (p<0.0001). There was a significant improvement in fasting hyperglycemia, HbA1C and significant decrease in LDL-cholesterol, fibrinogen and C-reactive protein. Modest reduction in HOMA-IR was observed. The change in weight was positively associated with LAEI, SAEI, total cholesterol, insulin and HOMA-IR.
Moderate weight loss induced by nutritional and exercise intervention improved small and large artery elasticity. The increase in arterial elasticity was associated with improvement in glucose and lipids homeostasis as well as markers of inflammation.
肥胖与动脉僵硬度增加有关，动脉僵硬度是血管壁损伤的早期标志物。然而，关于有意减肥对血管的长期影响的数据有限。本研究的目的是评估营养和运动干预引起的体重减轻对参加减肥计划的肥胖患者动脉顺应性、代谢和炎症参数的影响。
在一项开放标签的前瞻性研究中，37名肥胖受试者参加了为期24周的营养和运动干预计划。在基线和研究结束时使用脉搏波轮廓分析（HDI CR - 2000，明尼苏达州伊根）评估动脉弹性。在基线和6个月后测量空腹血糖、糖化血红蛋白（HbA1C）、胰岛素、血脂谱、高敏C反应蛋白（hs - CRP）、纤维蛋白原。通过稳态模型评估 - 胰岛素抵抗（HOMA - IR）评估胰岛素抵抗。
体重指数（BMI）从基线时的36.1±7.4kg/m²降至6个月后的32.8±7.4kg/m²（p<0.0001）。在研究期间，大动脉弹性指数（LAEI）从12.1±4.1增加到15.8±4.7ml/mmHg×10（p<0.0001）。小动脉弹性指数（SAEI）从4.4±2.4增加到5.5±2.7ml/mmHg×100（p<0.0001）。空腹血糖过高、糖化血红蛋白有显著改善，低密度脂蛋白胆固醇、纤维蛋白原和C反应蛋白显著降低。观察到HOMA - IR有适度降低。体重变化与LAEI、SAEI、总胆固醇、胰岛素和HOMA - IR呈正相关。
营养和运动干预引起的适度体重减轻改善了小动脉和大动脉弹性。动脉弹性的增加与葡萄糖和脂质稳态以及炎症标志物的改善有关。
