Ghachem Ahmed, Prud'homme Denis, Rabasa-Lhoret Rémi, Brochu Martin
1Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada 2Research Centre on Aging, Social Services and Health Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Quebec, Canada 3Institut de Recherche de l'Hôpital Montfort, Ottawa, Ontario, Canada 4School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada 5Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada 6Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada.
Menopause. 2017 Aug;24(8):908-915. doi: 10.1097/GME.0000000000000862.
To compare the effects of a caloric restriction (CR) on body composition, lipid profile, and glucose homeostasis in obese postmenopausal women with and without metabolic syndrome (MetS).
Secondary analyses were performed on 73 inactive obese postmenopausal women (age 57.7 ± 4.8 years; body mass index 32.4 ± 4.6 kg/m) who participated in the 6-month CR arm of a study of the Montreal-Ottawa New Emerging Team. The harmonized MetS definition was used to categorize participants with MetS (n = 20, 27.39%) and without MetS (n = 53, 72.61%). Variables of interest were: body composition (dual-energy X-ray absorptiometry), body fat distribution (computed tomography scan), glucose homeostasis at fasting state and during a euglycemic/hyperinsulinemic clamp, fasting lipids, and resting blood pressure.
By design, the MetS group had a worse cardiometabolic profile, whereas both groups were comparable for age. Fifty-five participants out of 73 displayed no change in MetS status after the intervention. Twelve participants out of 20 (or 60.0%) in the MetS group had no more MetS after weight loss (P = NS), whereas 6 participants out of 53 (or 11.3%) in the other group developed the MetS after the intervention (P = NS). Overall, indices of body composition and body fat distribution improved significantly and similarly in both groups (P between 0.03 and 0.0001). Furthermore, with the exception of triglyceride levels and triglycerides/high-density lipoprotein cholesterol ratio, which decrease significantly more in the MetS group (P ≤ 0.05), no difference was observed between groups for the other variables of the cardiometabolic profile.
Despite no overall significant effects on MetS, heteregeneous results were obtained in response to weight loss in the present study, with some improving the MetS, whereas other displaying deteriorations. Further studies are needed to identify factors and phenotypes associated with positive and negative cardiometabolic responses to CR intervention.
比较热量限制（CR）对患有和未患有代谢综合征（MetS）的肥胖绝经后女性身体成分、血脂谱和葡萄糖稳态的影响。
对73名不活跃的肥胖绝经后女性（年龄57.7±4.8岁；体重指数32.4±4.6kg/m²）进行二次分析，这些女性参与了蒙特利尔 - 渥太华新兴团队研究的6个月CR组。采用统一的MetS定义对患有MetS（n = 20，27.39%）和未患有MetS（n = 53，72.61%）的参与者进行分类。感兴趣的变量包括：身体成分（双能X线吸收法）、体脂分布（计算机断层扫描）、空腹状态和正常血糖/高胰岛素钳夹期间的葡萄糖稳态、空腹血脂和静息血压。
根据设计，MetS组的心脏代谢状况较差，而两组在年龄方面具有可比性。73名参与者中有55名在干预后MetS状态未发生变化。MetS组20名参与者中有12名（或60.0%）在体重减轻后不再患有MetS（P = 无显著性差异），而另一组53名参与者中有6名（或11.3%）在干预后患上了MetS（P = 无显著性差异）。总体而言，两组的身体成分和体脂分布指标均有显著且相似的改善（P在0.03至0.0001之间）。此外，除了甘油三酯水平和甘油三酯/高密度脂蛋白胆固醇比值在MetS组下降更为显著（P≤0.05）外，两组在心脏代谢状况的其他变量方面未观察到差异。
尽管对MetS没有总体显著影响，但本研究中体重减轻的反应结果存在异质性，一些人改善了MetS，而另一些人则出现恶化。需要进一步研究以确定与CR干预的心脏代谢阳性和阴性反应相关的因素和表型。
