Buscemi S, Caimi G, Verga S
Institute of Clinica Medica, University of Palermo, Italy.
Int J Obes Relat Metab Disord. 1996 Jan;20(1):41-6.
To investigate the changes of resting metabolic rate (RMR) and postabsorptive oxidation of carbohydrates (CHO), lipids (LIP) and proteins (PT) in morbidly obese subjects after long-term stable massive weight reduction.
Longitudinal, intervention study of a bilio-pancreatic by-pass.
Ten (Four men, six women) obese subjects (BMI: 53.7 +/- 2.1 kg/m2, mean +/- s.e.m.) and 12 (three men, nine women) control subjects (BMI: 21.4 +/- 1.0 kg/m2).
RMR and substrates oxidation (indirect calorimetry), body composition (bioelectrical impedance), plasma concentrations of glucose, FFA, insulin and thyroid hormones before (T0, prior to surgery), during (T1: 1-3 months, and T2: 9-16 months following surgery) and after (T3: 36-42 months following surgery) massive weight loss.
At T3 BMI proved to be stably reduced to 32.9 +/- 1.3 (P < 0.0001). The RMR progressively reduced both in absolute value (T3: -2566 kJ/24 h; P < 0.0001 vs T0) and normalized for fat-free mass (FFM; T0: 123 +/- 3.8, T1: 109 +/- 3.3, T2: 112 +/- 7.1, T3: 105 +/- 4.6 kJ/kg-FFM.24 h; P < 0.05). At T3 the normalized RMR became significantly lower than the corresponding value of a control group (118 +/- 2.5 kJ/kg-FFM.24 h; P < 0.01). The long term trend in substrates oxidation showed that CHO oxidation increased while LIP oxidation decreased; PT oxidation did not significantly change for the whole of the study.
Previously morbid obese subjects have an energy sparing metabolism and a normal postabsorptive oxidation of LIP and CHO.
研究病态肥胖受试者长期稳定大幅减重后静息代谢率（RMR）以及碳水化合物（CHO）、脂质（LIP）和蛋白质（PT）餐后氧化的变化。
胆胰转流术的纵向干预研究。
10名（4名男性，6名女性）肥胖受试者（BMI：53.7±2.1kg/m²，均值±标准误）和12名（3名男性，9名女性）对照受试者（BMI：21.4±1.0kg/m²）。
在大幅减重前（T0，手术前）、期间（T1：术后1 - 3个月，以及T2：术后9 - 16个月）和之后（T3：术后36 - 42个月）测量RMR和底物氧化（间接测热法）、身体成分（生物电阻抗）、血浆葡萄糖、游离脂肪酸（FFA）、胰岛素和甲状腺激素浓度。
在T3时，BMI稳定降至32.9±1.3（P < 0.0001）。RMR的绝对值逐渐降低（T3：-2566kJ/24小时；与T0相比，P < 0.0001），并且按去脂体重（FFM）标准化后也降低（T0：123±3.8，T1：109±3.3，T2：112±7.1，T3：105±4.6kJ/kg-FFM·24小时；P < 0.05）。在T3时，标准化的RMR显著低于对照组的相应值（118±2.5kJ/kg-FFM·24小时；P < 0.01）。底物氧化的长期趋势表明，CHO氧化增加而LIP氧化减少；在整个研究过程中，PT氧化没有显著变化。
既往病态肥胖受试者具有节约能量的代谢以及正常的LIP和CHO餐后氧化。
