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超重和肥胖成年人减肥和维持体重对脂蛋白胰岛素抵抗评分的影响。

Effects of Weight Loss and Weight Maintenance on Lipoprotein Insulin Resistance Scores in Adults with Overweight and Obesity.

机构信息

Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA.

Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA.

出版信息

Metab Syndr Relat Disord. 2024 Oct;22(8):598-607. doi: 10.1089/met.2023.0180. Epub 2024 Aug 20.

DOI:10.1089/met.2023.0180
PMID:39163283
Abstract

An elevated lipoprotein insulin resistance (LP-IR) score corresponds to insulin resistance in adults with overweight and obesity, yet data are lacking regarding the impact of exercise interventions on LP-IR. The purpose of this secondary analysis was to evaluate the effects of a weight loss and weight maintenance intervention on LP-IR score in adults with overweight and obesity. Thirty sedentary adults with overweight and obesity completed a 10-week OPTIFAST weight loss program with supervised aerobic exercise to achieve clinical weight loss (CWL) (≥7% from baseline). Aerobic exercise volume increased weekly until 700 MET min/week was reached. Participants who reached CWL were randomized to groups at volumes at either physical activity (PA-REC) or weight maintenance (WM-REC) recommendations (weeks 11-28). Plasma blood samples were analyzed via nuclear magnetic resonance spectroscopy at baseline, after weight loss (week 10), and following weight maintenance (week 28). Following the weight loss phase, on average, participants significantly ( < 0.001) reduced LP-IR score (-12.1 ± 13.5), body weight (-8.9 ± 2.7%), and waist circumference (-7.7 ± 4.1 cm). During the weight maintenance phase, there were no changes in LP-IR score between exercise groups (PA-REC: 4.1 ± 13.6; WM-REC: -2.0 ± 11.2; = 0.7). The PA-REC group had improvements in LP-IR score from baseline (49.8 ± 24.6 to 36.6 ± 27.6, < 0.001), yet there were no within-group changes during the weight maintenance phase ( > 0.05). LP-IR score improved during weight loss in adults with overweight and obesity and were sustained during the weight maintenance phase in the PA-REC group. Aerobic exercise at least at minimum guidelines following CWL can preserve LP-IR score improvements and may indicate a reduced T2DM risk in adults with overweight and obesity.

摘要

脂蛋白胰岛素抵抗(LP-IR)评分升高与超重和肥胖成年人的胰岛素抵抗相关,但目前缺乏关于运动干预对 LP-IR 的影响的数据。本二次分析的目的是评估减肥和体重维持干预对超重和肥胖成年人 LP-IR 评分的影响。

30 名久坐的超重和肥胖成年人完成了为期 10 周的 OPTIFAST 减肥计划,包括监督下的有氧运动以实现临床减肥(从基线下降≥7%)。有氧运动量每周增加,直到达到 700METmin/周。达到临床减肥的参与者被随机分为两组,分别按照体力活动(PA-REC)或体重维持(WM-REC)推荐量(第 11-28 周)进行运动。在基线、减肥后(第 10 周)和体重维持后(第 28 周),通过磁共振波谱分析血浆血液样本。

在减肥阶段后,平均而言,参与者的 LP-IR 评分显著(<0.001)降低(-12.1±13.5)、体重(-8.9±2.7%)和腰围(-7.7±4.1cm)。在体重维持阶段,两组之间的 LP-IR 评分没有变化(PA-REC:4.1±13.6;WM-REC:-2.0±11.2;=0.7)。PA-REC 组的 LP-IR 评分从基线开始改善(49.8±24.6 至 36.6±27.6,<0.001),但在体重维持阶段无组内变化(>0.05)。

超重和肥胖成年人在减肥过程中 LP-IR 评分得到改善,并在 PA-REC 组的体重维持阶段得到维持。CWL 后至少达到最低指南的有氧运动可以保持 LP-IR 评分的改善,可能表明超重和肥胖成年人的 2 型糖尿病风险降低。

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