Friedman C I, Falko J M, Patel S T, Kim M H, Newman H A, Barrows H
J Clin Endocrinol Metab. 1982 Aug;55(2):258-62. doi: 10.1210/jcem-55-2-258.
An increase in high density lipoprotein-cholesterol (HDL-C) and a reduction in low density lipoprotein-cholesterol (LDL-C) accompany weight reduction in obese males. In contrast, obese females have had variable responses in these two lipoproteins after weight reduction. To evaluate the effects of weight reduction in obese women, 15 morbidly obese eugonadotropic women of reproductive age had serum lipids and lipoproteins measured before and after achieving a stable and reduced weight by either diet and/or a gastric stapling procedure. Total testosterone (T), free testosterone (free T), and testosterone-binding globulin serum concentrations were also determined before and after achieving a stable reduced weight to assess the role of androgens in modulating any lipoprotein changes. In 10 subjects, lipid analysis was also performed during active weight loss. Total serum triglycerides fell from 106 +/- 53 to 76 +/- 30 mg/dl during active weight loss (P less than 0.025). Total cholesterol, LDL-C, HDL-C, and the LDL-C to HDL-C ratio did not change. In contrast, after achieving a stable reduced weight (mean weight reduction, 25.9 +/- 6.7 kg), HDL-C rose from 24 +/- 8 to 32 +/- 9 mg/dl (P less than 0.005). This was accompanied by a reduction in LDL-C from 145 +/- 23 to 135 +/- 30 mg/dl (P less than 0.01) and in the LDL-C to HDL-C ratio from 6.7 +/- 2.6 to 4.8 +/- 1.9 (P less than 0.001). Total triglycerides and total cholesterol were unchanged. After obtaining a stable reduced weight, testosterone-binding globulin increased and free T fell, but no significant correlation existed between the changes in androgens and the changes in lipoprotein responses. Thus, in morbidly obese women, weight reduction increases HDL-C and lowers LDL-C serum concentrations. The reduction in the LDL-C to HDL-C ratio suggests that weight loss may favorably reduce the risk of coronary artery disease in these patients. A concurrent reduction of free T with weight loss does not appear to be a major controlling influence in these lipoprotein alterations.
肥胖男性体重减轻时会伴随高密度脂蛋白胆固醇（HDL-C）升高和低密度脂蛋白胆固醇（LDL-C）降低。相比之下，肥胖女性体重减轻后这两种脂蛋白的反应则各不相同。为评估肥胖女性体重减轻的影响，15名患有肥胖症的生殖年龄正常促性腺激素女性在通过饮食和/或胃吻合术实现体重稳定减轻前后，测定了血脂和脂蛋白。在体重稳定减轻前后还测定了总睾酮（T）、游离睾酮（游离T）和睾酮结合球蛋白血清浓度，以评估雄激素在调节脂蛋白变化中的作用。在10名受试者中，在体重积极减轻期间也进行了血脂分析。在体重积极减轻期间，总血清甘油三酯从106±53降至76±30mg/dl（P＜0.025）。总胆固醇、LDL-C、HDL-C以及LDL-C与HDL-C的比值未发生变化。相比之下，在体重稳定减轻后（平均体重减轻25.9±6.7kg），HDL-C从24±8升至32±9mg/dl（P＜0.005）。同时，LDL-C从145±23降至135±30mg/dl（P＜0.01），LDL-C与HDL-C的比值从6.7±2.6降至4.8±1.9（P＜0.001）。总甘油三酯和总胆固醇未发生变化。体重稳定减轻后，睾酮结合球蛋白增加，游离T下降，但雄激素变化与脂蛋白反应变化之间不存在显著相关性。因此，在患有肥胖症的女性中，体重减轻会使HDL-C升高，LDL-C血清浓度降低。LDL-C与HDL-C比值的降低表明，体重减轻可能有利于降低这些患者患冠状动脉疾病的风险。体重减轻时游离T的同时降低似乎并非这些脂蛋白改变的主要控制因素。
