Wirth A, Steinmetz B
Teutoburger Wald Clinic, Bad Rothenfelde, Germany.
Obes Res. 1998 Nov;6(6):393-9. doi: 10.1002/j.1550-8528.1998.tb00370.x.
In weight-reducing programs, men usually display greater improvement in metabolic risk factors than women. This gender difference may be related to enhanced weight and fat loss due to a greater energy deficit in men. To clarify the relationship between changes in metabolic profile, body fat composition, and weight loss, both sexes were studied under a regimen in which similar amounts of weight were lost.
A cross-sectional study using anthropometric (body mass index and waist-to-hip ratio), impedance (bioelectrical impedance analysis) and ultrasound measurement methods (thickness of subcutaneous fat layers, intra-abdominal sagittal diameter) were conducted. The metabolic risk profile was determined by measuring lipids, lipoproteins, and blood pressure. The weight loss program lasted 15 weeks: 3 weeks under controlled conditions in the hospital and 12 weeks on an ambulatory basis. Patients were instructed to follow a mixed diet. Calorie intake was restricted to 1500 kcal/day for the men and 1200 kcal/day for the women. Thirty-two subjects with obesity (16 men and 16 women), with a mean body mass index of 35 kg/m2--matched with regard to age, height, and body weight--took part in the study.
As expected, weight loss was similar for both sexes (-13.4 kg vs. -12.8 kg). Also, body fat mass changed to the same extent in absolute and relative terms. The waist-to-hip ratio was identical before and after treatment in both sexes. The men lost more visceral fat than the women. This result is based on changes in intra-abdominal diameter as well as abdominal subcutaneous fat in relation to waist circumference. Changes in abdominal diameter were paralleled by reductions in triglycerides and increases in high-density lipoprotein-cholesterol. Subcutaneous fat loss was more pronounced in women than in men.
Where absolute and relative reductions in body weight and body fat are similar, men mobilize more intra-abdominal fat than women, whereas women lose more subcutaneous fat. The greater reduction in intra-abdominal fat seen in men is accompanied by a more pronounced improvement in the metabolic risk profile. Therefore, greater improvement of risk factors in men is not only related to a greater negative energy balance, as shown in most studies, but is also sex-specific.
在减肥项目中，男性通常在代谢危险因素方面比女性有更大改善。这种性别差异可能与男性因能量亏空更大而导致体重和脂肪减少更多有关。为了阐明代谢状况变化、身体脂肪组成与体重减轻之间的关系，对两性在体重减轻量相似的方案下进行了研究。
采用人体测量学（体重指数和腰臀比）、阻抗（生物电阻抗分析）和超声测量方法（皮下脂肪层厚度、腹内矢状径）进行横断面研究。通过测量血脂、脂蛋白和血压来确定代谢风险状况。减肥项目持续15周：在医院控制条件下进行3周，门诊进行12周。患者被指导遵循混合饮食。男性的热量摄入限制为每天1500千卡，女性为每天1200千卡。32名肥胖受试者（16名男性和16名女性）参与了研究，他们的平均体重指数为35kg/m²，在年龄、身高和体重方面相互匹配。
正如预期的那样，两性的体重减轻相似（分别为-13.4kg和-12.8kg）。此外，身体脂肪量在绝对和相对方面的变化程度相同。两性治疗前后的腰臀比相同。男性比女性减掉更多的内脏脂肪。这一结果基于腹内直径以及腹部皮下脂肪相对于腰围的变化。腹内直径的变化与甘油三酯的降低和高密度脂蛋白胆固醇的升高同时出现。女性皮下脂肪的减少比男性更明显。
在体重和身体脂肪的绝对和相对减少相似的情况下，男性比女性动员更多的腹内脂肪，而女性减掉更多的皮下脂肪。男性腹内脂肪减少更多伴随着代谢风险状况更明显的改善。因此，男性危险因素的更大改善不仅如大多数研究所示与更大的负能量平衡有关，而且还具有性别特异性。
