Myette-Côté Étienne, Doucet Éric, Prud'homme Denis, Rabasa-Lhoret Rémi, Lavoie Jean-Marc, Brochu Martin
From the 1Faculty of Physical Education and Sport, Université de Sherbrooke, Sherbrooke, Québec, Canada; 2Centre de santé et de services sociaux, Institut universitaire de gériatrie de Sherbrooke, Sherbrooke, Québec, Canada; 3School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; 4Institut de recherche de l'Hôpital Montfort, Ottawa, Ontario, Canada; 5Department of Nutrition, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; 6Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada; and 7Department of Kinesiology, Université de Montréal, Montréal, Québec, Canada.
Menopause. 2015 Jan;22(1):96-103. doi: 10.1097/GME.0000000000000273.
This study aims to investigate individual characteristics that explain interindividual variations in glucose disposal in response to a 6-month weight loss program in obese postmenopausal women.
The cohort was divided into tertiles based on changes in glucose disposal after weight loss. Only women in the upper tertile (positive responders: Δ glucose disposal ≥ 0.92 mg/kg/min; n = 19) and lower tertile (negative responders: Δ glucose disposal ≤ -0.23 mg/kg/min; n = 19) were considered for analyses. Outcome measures included body weight, lean body mass (LBM), LBM index (= LBM / height [m]), fat mass (FM), FM index (= FM / height [m]), visceral fat, subcutaneous abdominal fat, high-sensitivity C-reactive protein (hsCRP) levels, interleukin-6, lipid profile, physical activity levels, fasting blood glucose and insulin levels, glucose disposal by hyperinsulinemic-euglycemic clamp technique, and resting blood pressure.
At baseline, positive responders had higher triglycerides and hsCRP levels and lower glucose disposal (0.01 < P < 0.05) than negative responders. Except for visceral fat, the entire cohort showed significant decreases in all measures of body composition (P < 0.005) after weight loss, with greater decreases in body weight, body mass index, and FM index in positive responders (P < 0.005). Finally, data revealed that only positive responders showed decreases in LBM, LBM index, and hsCRP levels after weight loss (P between 0.01 and 0.001).
An important interindividual variability in changes in glucose disposal after weight loss is observed. Interestingly, participants who display improvements in glucose disposal also show significant decreases in LBM, LBM index, and hsCRP after weight loss.
本研究旨在调查个体特征，这些特征可解释肥胖绝经后女性在为期6个月的体重减轻计划中，葡萄糖代谢个体间差异的原因。
根据体重减轻后葡萄糖代谢的变化，将该队列分为三分位数。仅考虑上三分位数（阳性反应者：葡萄糖代谢变化量≥0.92mg/kg/min；n = 19）和下三分位数（阴性反应者：葡萄糖代谢变化量≤ -0.23mg/kg/min；n = 19）的女性进行分析。观察指标包括体重、瘦体重（LBM）、LBM指数（= LBM /身高[m]）、脂肪量（FM）、FM指数（= FM /身高[m]）、内脏脂肪、腹部皮下脂肪、高敏C反应蛋白（hsCRP）水平、白细胞介素-6、血脂谱、身体活动水平、空腹血糖和胰岛素水平、通过高胰岛素-正葡萄糖钳夹技术测定的葡萄糖代谢以及静息血压。
在基线时，阳性反应者的甘油三酯和hsCRP水平较高，葡萄糖代谢较低（0.01 < P < 0.05），低于阴性反应者。除内脏脂肪外，整个队列在体重减轻后所有身体成分指标均显著下降（P < 0.005），阳性反应者的体重、体重指数和FM指数下降幅度更大（P < 0.005）。最后，数据显示只有阳性反应者在体重减轻后LBM、LBM指数和hsCRP水平下降（P在0.01至0.001之间）。
观察到体重减轻后葡萄糖代谢变化存在重要的个体间差异。有趣的是，葡萄糖代谢改善的参与者在体重减轻后LBM、LBM指数和hsCRP也显著下降。
