Gulati Seema, Misra Anoop, Tiwari Rajneesh, Sharma Meenu, Pandey Ravindra M, Yadav Chander Prakash
1Diabetes Foundation (India),New Delhi 110016,India.
4Fortis C-DOC Center for Excellence for Diabetes, Metabolic Disease and Endocrinology,New Delhi 110048,India.
Br J Nutr. 2017 Jun;117(11):1531-1540. doi: 10.1017/S0007114517001295. Epub 2017 Jun 27.
The aim of the present study was to evaluate the impact of a high-protein meal replacement (HPMR) on weight and metabolic, lipid and inflammatory parameters in overweight/obese Asian Indians. In this 12-week open-label, parallel-arm randomised controlled trial, 122 overweight/obese men and women were administered either a HPMR or a control diet after 2 weeks of diet and exercise run-in. Body weight, waist circumference (WC), percentage body fat (%BF), fasting blood glucose, post-oral glucose tolerance test (post-OGTT) blood glucose, fasting and post-OGTT serum insulin, lipid profile, high-sensitivity C-reactive protein (hs-CRP), kidney function and hepatic aminotransferases were assessed before and after the intervention. Additional improvement in mean values for the following parameters in the HPMR group compared with the control group was observed: body weight, 4·9 % (95 % CI 3·8, 6·1; P<0·001); WC, 3·8 % (95 % CI 2·5, 5·1; P<0·001); %BF, 6·3 % (95 % CI 4·3, 8·2; P<0·001); systolic blood pressure, 2·8 % (95 % CI 0·4, 5·1; P=0·002); diastolic blood pressure, 3·5 % (95 % CI 0·7, 6·3; P= 0·01); post-OGTT blood glucose, 7·3 % (95 % CI 1·4, 13·1; P=0·02); total cholesterol, 2·5 % (95 % CI 1·6, 3·5; P<0·001); LDL-cholesterol, 7·3 % (95 % CI 1·7, 12·9; P<0·01); alanine aminotransferase, 22·0 % (95 % CI 2·1, 42; P=0·03) and aspartate aminotransferase, 15·2 % (95 % CI 0·9, 29·5; P=0·04). The absolute reduction in BMI was 0·9 units in the intervention arm compared with the control arm (-0·9 %, 95 % CI -1·4, -0·5; P<0·001) and in serum TAG was 11·9 mg/dl (-11·9 mg/dl, 95 % CI -21·1, -2·7; P<0·01). The reduction in fasting serum insulin in the intervention v. the control arm was 3·8 v. 0 % (P=0·002); post-OGTT serum insulin was 50·3 v. 77·3 mU/l (P=0·005); and hs-CRP, 16·7 % v. 0 % (P=0·002). These findings show that intervention with HPMR may lead to significant weight loss and improvement in obesity measures, metabolic, lipid and inflammatory parameters and hepatic transaminases in overweight/obese Asian Indians.
本研究的目的是评估高蛋白代餐（HPMR）对超重/肥胖亚洲印度人体重以及代谢、血脂和炎症参数的影响。在这项为期12周的开放标签、平行组随机对照试验中，122名超重/肥胖男性和女性在经过2周的饮食和运动预试验后，被给予HPMR或对照饮食。在干预前后评估体重、腰围（WC）、体脂百分比（%BF）、空腹血糖、口服葡萄糖耐量试验（OGTT）后血糖、空腹和OGTT后血清胰岛素、血脂谱、高敏C反应蛋白（hs-CRP）、肾功能和肝转氨酶。与对照组相比，HPMR组在以下参数的平均值上有进一步改善：体重，4.9%（95%CI 3.8，6.1；P<0.001）；WC，3.8%（95%CI 2.5，5.1；P<0.001）；%BF，6.3%（95%CI 4.3，8.2；P<0.001）；收缩压，2.8%（95%CI 0.4，5.1；P=0.002）；舒张压，3.5%（95%CI 0.7，6.3；P=0.01）；OGTT后血糖，7.3%（95%CI 1.4，13.1；P=0.02）；总胆固醇，2.5%（95%CI 1.6，3.5；P<0.001）；低密度脂蛋白胆固醇，7.3%（95%CI 1.7，12.9；P<0.01）；丙氨酸转氨酶，22.0%（95%CI 2.1，42；P=0.03）和天冬氨酸转氨酶，15.2%（95%CI 0.9，29.5；P=0.04）。与对照组相比，干预组的BMI绝对降低0.9个单位（-0.9%，95%CI -1.4，-0.5；P<0.001），血清甘油三酯降低11.9mg/dl（-11.9mg/dl，95%CI -21.1，-2.7；P<0.01）。干预组与对照组相比，空腹血清胰岛素降低3.8%，而对照组未降低（P=0.002）；OGTT后血清胰岛素分别为50.3和77.3mU/l（P=0.005）；hs-CRP降低16.7%，而对照组未降低（P=0.002）。这些发现表明，采用HPMR进行干预可能会使超重/肥胖亚洲印度人显著减重，并改善肥胖指标、代谢、血脂和炎症参数以及肝转氨酶。
