Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands.
Department of Medical Basic Sciences, Faculty of Applied Medical Sciences, AlBaha University, AlBaha 65779-7738, Saudi Arabia.
Nutrients. 2022 Apr 8;14(8):1546. doi: 10.3390/nu14081546.
Cross-sectional studies have shown that obesity is associated with lower intestinal cholesterol absorption and higher endogenous cholesterol synthesis. These metabolic characteristics have also been observed in patients with type 2 diabetes, metabolic syndrome, steatosis or cholestasis. The number of intervention studies evaluating the effect of weight loss on these metabolic characteristics is, however, limited, while the role of the different fat compartments has not been studied into detail. In a randomized trial, abdominally obese men (N = 54) followed a 6-week very low caloric (VLCD) diet, followed by a 2 week weight-maintenance period. Non-cholesterol sterols were measured at baseline and after 8 weeks, and compared to levels in lean participants (N = 25). After weight loss, total cholesterol (TC)-standardized cholestanol levels increased by 0.18 µmol/mmol (p < 0.001), while those of campesterol and lathosterol decreased by 0.25 µmol/mmol (p < 0.05) and 0.39 µmol/mmol (p < 0.001), respectively. Moreover, after weight loss, TC-standardized lathosterol and cholestanol levels were comparable to those of lean men. Increases in TC-standardized cholestanol after weight loss were significantly associated with changes in waist circumference (p < 0.01), weight (p < 0.001), BMI (p < 0.001) and visceral fat (p < 0.01), but not with subcutaneous and intrahepatic lipids. In addition, cross-sectional analysis showed that visceral fat fully mediated the association between BMI and TC-standardized cholestanol levels. Intrahepatic lipid content was a partial mediator for the association between BMI and TC-standardized lathosterol levels. In conclusion, diet-induced weight loss decreased cholesterol synthesis and increased cholesterol absorption. The increase in TC-standardized cholestanol levels was not only related to weight loss, but also to a decrease in visceral fat volume. Whether these metabolic changes ameliorate other metabolic risk factors needs further study.
横断面研究表明，肥胖与较低的肠道胆固醇吸收和较高的内源性胆固醇合成有关。这些代谢特征也在 2 型糖尿病、代谢综合征、脂肪变性或胆汁淤积患者中观察到。然而，评估减肥对这些代谢特征影响的干预研究数量有限，而不同脂肪隔室的作用尚未详细研究。在一项随机试验中，腹部肥胖男性（N=54）遵循 6 周极低热量（VLCD）饮食，然后进行 2 周的体重维持期。在基线和 8 周后测量非胆固醇甾醇，并与瘦参与者（N=25）的水平进行比较。减肥后，总胆固醇（TC）标准化胆甾烷醇水平增加了 0.18µmol/mmol（p<0.001），而菜油甾醇和羊毛甾醇的水平分别降低了 0.25µmol/mmol（p<0.05）和 0.39µmol/mmol（p<0.001）。此外，减肥后，TC 标准化羊毛甾醇和胆甾烷醇水平与瘦男性相当。减肥后 TC 标准化胆甾烷醇的增加与腰围（p<0.01）、体重（p<0.001）、BMI（p<0.001）和内脏脂肪（p<0.01）的变化显著相关，但与皮下和肝内脂质无关。此外，横断面分析表明，内脏脂肪完全介导了 BMI 和 TC 标准化胆甾烷醇水平之间的关联。肝内脂质含量是 BMI 和 TC 标准化羊毛甾醇水平之间关联的部分介导物。总之，饮食诱导的体重减轻降低了胆固醇合成并增加了胆固醇吸收。TC 标准化胆甾烷醇水平的升高不仅与体重减轻有关，还与内脏脂肪体积的减少有关。这些代谢变化是否能改善其他代谢危险因素需要进一步研究。
