Krotkiewski M, Sjöström L, Björntorp P, Carlgren G, Garellick G, Smith U
Int J Obes. 1977;1(4):395-416.
Ninety obese adult women were analysed with respect to adipose tissue cellularity and divided into hypertrophic, hyperplastic and combined groups of obesity. Their spontaneous body weight development was analysed over a period of six years. A reference group, with normal body weight, gained weight at an average of 0.25 kg per year. Patients with hyperplastic and combined forms of obesity gained significantly more (2.5 and 3.1 kg per year, respectively) when essentially untreated. The increase for the patients with hypertrophic obesity did not differ significantly from the reference group. During a standardized treatment period on an energy reduced diet (1100 kcal/day or 4600 kJ/day) the hypertrophic, hyperplastic and combined groups reduced by 11, 15 and 20 kg, respectively. There were strong positive correlations between total weight reduction and rate of weight reduction on the one hand and FCN and initial body weight on the other. The combined and hyperplastic groups were on average able to maintain their reduced weight for 12 and 15 weeks, respectively, while the hypertrophic group managed for 51 weeks. There was a strong negative correlation between duration of steady weight after weight reduction and FCN. When the relapse started the rate of regain was three times faster in the hyperplastic and combined groups than in the hypertrophic group. The rate of regain correlated positively with FCN. Thus, the patients demonstrated a characteristic three phase pattern in weight change with a period of reduction followed by periods of steady weight and of weight gain. The higher FCN, the faster this cycle was completed. It is concluded that the long-term prognosis for weight reduction is worse for hypercellular forms of obesity than for the hypertrophic form. However, this does not mean that patients with hypercellular forms of obesity should not be treated at all since their serious spontaneous weight development might be lessened by repeated treatments.
对90名肥胖成年女性的脂肪组织细胞构成进行了分析，并将她们分为肥胖的肥大型、增生型和混合型。对她们在六年时间里的自然体重变化进行了分析。一个体重正常的参照组平均每年增重0.25千克。增生型和混合型肥胖患者在基本未接受治疗的情况下体重显著增加更多（分别为每年2.5千克和3.1千克）。肥大型肥胖患者的体重增加与参照组无显著差异。在能量减少饮食（1100千卡/天或4600千焦/天）的标准化治疗期间，肥大型、增生型和混合型组分别减重11千克、15千克和20千克。总体减重和减重速率一方面与脂肪细胞数量（FCN）和初始体重另一方面之间存在强正相关。混合型和增生型组平均分别能够将减轻后的体重维持12周和15周，而肥大型组则维持了51周。体重减轻后体重稳定期的时长与FCN之间存在强负相关。当体重开始反弹时，增生型和混合型组的体重恢复速率比肥大型组快三倍。体重恢复速率与FCN呈正相关。因此，患者在体重变化方面呈现出一种典型的三个阶段模式，先是减重期，接着是体重稳定期，然后是体重增加期。FCN越高，这个循环完成得越快。得出的结论是，细胞增多型肥胖的长期减重预后比肥大型肥胖更差。然而，这并不意味着细胞增多型肥胖患者完全不应接受治疗，因为通过反复治疗可能会减轻他们严重的自然体重增加情况。
