Ožvald Ivan, Božičević Dragan, Duh Lidija, Vinković Vrček Ivana, Pavičić Ivan, Domijan Ana-Marija, Milić Mirta
Duga Resa Special Hospital for Extended Treatment, 47250 Duga Resa, Croatia.
Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health (IMROH), Ksaverska Cesta 2, 10001 Zagreb, Croatia.
Nutrients. 2021 Dec 14;13(12):4468. doi: 10.3390/nu13124468.
Although a very-low-calorie diet (VLCD) is considered safe and has demonstrated benefits among other types of diets, data are scarce concerning its effects on improving health and weight loss in severely obese patients. As part of the personalized weight loss program developed at the Duga Resa Special Hospital for Extended Treatment, Croatia, we evaluated anthropometric, biochemical, and permanent DNA damage parameters (assessed with the cytochalasin B-blocked micronucleus assay-CBMN) in severely obese patients (BMI ≥ 35 kg m) after 3-weeks on a 567 kcal, hospital-controlled VLCD. This is the first study on the permanent genomic (in)stability in such VLCD patients. VLCDs caused significant decreases in weight (loss), parameters of the lipid profile, urea, insulin resistance, and reduced glutathione (GSH). Genomic instability parameters were lowered by half, reaching reference values usually found in the healthy population. A correlation was found between GSH decrease and reduced DNA damage. VLCDs revealed susceptible individuals with remaining higher DNA damage for further monitoring. In a highly heterogeneous group (class II and III in obesity, differences in weight, BMI, and other categories) consisting of 26 obese patients, the approach demonstrated its usefulness and benefits in health improvement, enabling an individual approach to further monitoring, diagnosis, treatment, and risk assessment based on changing anthropometric/biochemical VLCD parameters, and CBMN results.
尽管极低热量饮食（VLCD）被认为是安全的，并且在其他类型的饮食中已显示出益处，但关于其对重度肥胖患者改善健康和减肥效果的数据却很少。作为克罗地亚杜加雷萨长期治疗专科医院制定的个性化减肥计划的一部分，我们评估了重度肥胖患者（BMI≥35 kg/m²）在接受为期3周、热量为567千卡且由医院控制的VLCD饮食后的人体测量学、生化指标以及永久性DNA损伤参数（通过细胞松弛素B阻断微核试验-CBMN进行评估）。这是第一项关于此类VLCD患者永久性基因组（不）稳定性的研究。VLCD导致体重（减轻）、血脂参数、尿素、胰岛素抵抗和还原型谷胱甘肽（GSH）显著下降。基因组不稳定性参数降低了一半，达到了通常在健康人群中发现的参考值。发现GSH下降与DNA损伤减少之间存在相关性。VLCD揭示了仍有较高DNA损伤的易感个体，需要进一步监测。在一个由26名肥胖患者组成的高度异质性群体（肥胖的II级和III级，体重、BMI和其他类别存在差异）中，该方法在改善健康方面显示出其有用性和益处，能够基于人体测量学/生化VLCD参数和CBMN结果，采取个体化方法进行进一步监测、诊断、治疗和风险评估。
