Department of Medicine, Atlanta VA Medical Center, Emory University School of Medicine, Atlanta, Georgia, USA,
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Ann Nutr Metab. 2019;74(2):149-155. doi: 10.1159/000497066. Epub 2019 Feb 12.
Whether improvements in cardiometabolic health following weight loss (WL) are associated with changes in regional body fat distribution (gluteal vs. -android) is not well documented.
Older (age: 70 ± 4 years; mean ± SD) adults with obesity were randomized to a 6-month WL program (WL; n = 47), accomplished using a hypocaloric, nutritionally complete, higher protein -(targeting ≥1.0 g/kg/day) meal plan, or a weight stability (WS; n = 49) program. Android, gynoid, visceral, and subcutaneous abdominal fat masses (via dual energy X-ray absorptiometry ) and fasting glucose and lipid profiles were assessed at baseline and 6 months.
The WL group lost more body weight (WL: -8.6% vs. WS: -1.7%, p < 0.01), resulting in a reduction in fat mass at each region only following WL (all p < 0.05). The decline in the ratio of android/gynoid fat mass also was significant only following WL, resulting in greater declines than WS (mean [95% CI]; WL: -0.026 [-0.040 to -0.011] vs. WS: 0.003 [-0.012 to 0.019] g, p < 0.01). The change in the ratio of visceral/subcutaneous abdominal fat mass was not significant in either group and did not differ between groups (WL: 0.65 [-0.38 to 1.68] vs. WS: 0.05 [-1.00 to 1.10] g, p = 0.42). In general, the improvements in glucose and lipid profiles were associated with declines in fat mass at the gynoid and android regions (r's = 0.20-0.42, all p < 0.05), particularly the visceral depot but not the ratios.
WL achieved via a hypocaloric, nutritionally complete, higher protein meal plan is effective in reducing body fat in the android, gynoid, and visceral depots, which relate to cardiometabolic improvements.
体重减轻（WL）后，心脏代谢健康的改善是否与身体脂肪分布区域（臀型与躯干型）的变化有关，目前尚未得到充分证实。
肥胖的老年人（年龄：70±4 岁；平均值±标准差）被随机分为 6 个月 WL 计划（WL；n=47）或体重稳定（WS；n=49）计划。采用低热量、营养完整、高蛋白（目标为≥1.0 g/kg/天）的膳食计划进行 WL，通过双能 X 射线吸收法（DXA）评估躯干型、臀型、内脏型和皮下腹部脂肪量以及空腹血糖和血脂谱。
WL 组体重减轻更多（WL：-8.6%，WS：-1.7%，p<0.01），仅 WL 后各部位脂肪量减少（均 p<0.05）。只有 WL 后，躯干型/臀型脂肪量比值下降显著，且比 WS 组下降更大（平均[95%CI]；WL：-0.026[-0.040 至-0.011]，WS：0.003[-0.012 至 0.019]，p<0.01）。两组内脏型/皮下腹部脂肪量比值变化均不显著，且两组间无差异（WL：0.65[-0.38 至 1.68]，WS：0.05[-1.00 至 1.10]，p=0.42）。一般而言，血糖和血脂谱的改善与臀型和躯干型脂肪量的下降相关（r 值为 0.20-0.42，均 p<0.05），特别是内脏脂肪，而不是脂肪比率。
通过低热量、营养完整、高蛋白膳食计划实现的 WL 可有效减少躯干型、臀型和内脏型脂肪，与心脏代谢改善相关。
