Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
J Gerontol A Biol Sci Med Sci. 2013 Jun;68(6):691-8. doi: 10.1093/gerona/gls236. Epub 2012 Nov 26.
Little is known about the effect of intentional weight loss and subsequent weight regain on cardiometabolic risk factors in older adults. The objective of this study was to determine how cardiometabolic risk factors change in the year following significant intentional weight loss in postmenopausal women, and if observed changes were affected by weight and fat regain.
Eighty, overweight and obese, older women (age = 58.8±5.1 years) were followed through a 5-month weight loss intervention and a subsequent 12-month nonintervention period. Body weight/composition and cardiometabolic risk factors (blood pressure; total, high-density lipoprotein, and low-density lipoprotein cholesterol; triglycerides; fasting glucose and insulin; and Homeostatic Model Assessment of Insulin Resistance) were analyzed at baseline, immediately postintervention, and 6- and 12-months postintervention.
Average weight loss during the 5-month intervention was 11.4±4.1kg and 31.4% of lost weight was regained during the 12-month follow-up. On average, all risk factor variables were significantly improved with weight loss but regressed toward baseline values during the year subsequent to weight loss. Increases in total cholesterol, triglycerides, glucose, insulin, and Homeostatic Model Assessment of Insulin Resistance during the postintervention follow-up were significantly (p < .05) associated with weight and fat mass regain. Among women who regained weight, model-adjusted total cholesterol (205.8±4.0 vs 199.7±2.9mg/dL), low-density lipoprotein cholesterol (128.4±3.4 vs 122.7±2.4mg/dL), insulin (12.6±0.7 vs 11.4±0.7mg/dL), and Homeostatic Model Assessment of Insulin Resistance (55.8±3.5 vs 50.9±3.7mg/dL) were higher at follow-up compared with baseline.
For postmenopausal women, even partial weight regain following intentional weight loss is associated with increased cardiometabolic risk. Conversely, maintenance of or continued weight loss is associated with sustained improvement in the cardiometabolic profile.
对于绝经后女性而言，体重减轻和随后的体重反弹对心血管代谢危险因素的影响知之甚少。本研究旨在确定绝经后超重和肥胖女性在经历显著的体重减轻后，心血管代谢危险因素在一年内会发生怎样的变化，以及观察到的变化是否受到体重和脂肪反弹的影响。
80 名超重和肥胖的老年女性（年龄=58.8±5.1 岁）参与了为期 5 个月的减肥干预和随后 12 个月的非干预期研究。在基线、干预结束后即刻、干预结束后 6 个月和 12 个月时，分析了体重/体成分和心血管代谢危险因素（血压；总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇；甘油三酯；空腹血糖和胰岛素；以及稳态模型评估的胰岛素抵抗）。
在 5 个月的干预期间，平均体重减轻了 11.4±4.1kg，而在随后的 12 个月随访期间，有 31.4%的体重减轻量得到了恢复。平均而言，所有危险因素变量在体重减轻时都显著改善，但在体重减轻后的一年中都回归到基线值。在干预结束后的随访期间，总胆固醇、甘油三酯、葡萄糖、胰岛素和稳态模型评估的胰岛素抵抗增加与体重和脂肪量的恢复显著相关（p<0.05）。在体重恢复的女性中，调整模型后的总胆固醇（205.8±4.0 与 199.7±2.9mg/dL）、低密度脂蛋白胆固醇（128.4±3.4 与 122.7±2.4mg/dL）、胰岛素（12.6±0.7 与 11.4±0.7mg/dL）和稳态模型评估的胰岛素抵抗（55.8±3.5 与 50.9±3.7mg/dL）在随访时均高于基线。
对于绝经后女性而言，即使是部分体重恢复，也与心血管代谢风险的增加有关。相反，保持或继续减肥与心血管代谢特征的持续改善有关。
