Kadowaki Yuri, Aoyama Tomohisa, Hada Yusuke, Aihara Masakazu, Sawada Mika, Sekine Rie, Itoh Hidetaka, Kadowaki Takashi, Kubota Naoto, Yamauchi Toshimasa
Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Department of Clinical Nutrition Therapy, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
Endocr J. 2025 Mar 3;72(3):307-317. doi: 10.1507/endocrj.EJ24-0315. Epub 2024 Nov 28.
The Japan Society for the Study of Obesity recommends a weight loss of 3% of body weight over a period of 3-6 months. However, the effects of rapid weight loss on the body composition have not yet been adequately studied. Therefore, we observed the changes in the body composition induced by rapid weight loss and its effects on the pathophysiological mechanisms involved in obesity. The subjects were people with obesity admitted to our institution. The goal was to achieve a 3-5% body weight loss in the subjects by combining a carbohydrate-controlled therapeutic diet of 25-30 kcal/day per kg target body weight, exercise therapy, and pharmacotherapy. The body composition was measured at admission and at discharge by the dual bioelectrical impedance analysis. After 2 weeks, the participants' body weight decreased by 4.2%; the visceral fat area decreased by 16.7%, the subcutaneous fat area by 2.4%, and the lean area by 4.0%. The moderate weight loss, moderate energy restriction and adequate protein intake significantly reduced the visceral fat area while allowing the lean area to be preserved. Improvements were also noted in the peripheral white blood cell count and C-reactive protein level. However, no statistically significant changes in homeostasis model assessment for insulin resistance and the adiponectin level were noted. Regarding clinical parameters, improvements of the systolic and diastolic blood pressures, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, and degree of microalbuminuria were observed. Short-term comprehensive treatment produced beneficial body composition changes, and improvements in the pathophysiological mechanisms involved in obesity.
日本肥胖研究学会建议在3至6个月的时间内减轻3%的体重。然而，快速减重对身体成分的影响尚未得到充分研究。因此，我们观察了快速减重引起的身体成分变化及其对肥胖相关病理生理机制的影响。研究对象为我院收治的肥胖患者。目标是通过将每公斤目标体重25 - 30千卡/天的碳水化合物控制治疗饮食、运动疗法和药物疗法相结合，使研究对象体重减轻3 - 5%。入院时和出院时通过双能生物电阻抗分析测量身体成分。2周后，参与者体重下降了4.2%；内脏脂肪面积下降了16.7%，皮下脂肪面积下降了2.4%，瘦体重面积下降了4.0%。适度减重、适度能量限制和充足的蛋白质摄入显著减少了内脏脂肪面积，同时使瘦体重面积得以保留。外周白细胞计数和C反应蛋白水平也有所改善。然而，胰岛素抵抗的稳态模型评估和脂联素水平没有统计学上的显著变化。在临床参数方面，观察到收缩压和舒张压、空腹血糖、甘油三酯、低密度脂蛋白胆固醇以及微量白蛋白尿程度均有所改善。短期综合治疗产生了有益的身体成分变化，并改善了肥胖相关的病理生理机制。
