减肥对内脏脂肪及胰岛素敏感性参数的影响

Effect of Weight Loss on Adipose Tissue Distribution and Insulin Sensitivity

目的 探讨减肥对脂肪分布及胰岛素敏感性参数的影响。方法 前瞻性自身对照研究。研究对象为 12名成年白人女性单纯肥胖患者。以低热量高蛋白饮食 4周 ,分别于试验前后进行系列检查。采用计算机断层扫描 ,测定内脏脂肪与皮下脂肪。采用正常血糖高胰岛素钳夹技术 ,测得胰岛素敏感性的各项参数。结果 经饮食减肥治疗 ,体重、体重指数、腰围、总脂肪量、内脏脂肪、皮下脂肪均显著性下降。而减肥前后的腰臀比、内脏脂肪及皮下脂肪占总脂肪量的百分比无显著性差异。空腹胰岛素水平、空腹胰岛素与空腹血糖之比减肥后有显著下降 ,而空腹 C肽无显著改变。胰岛素敏感指数显著性增加。结论 低热量高蛋白饮食疗法可使内脏脂肪和皮下脂肪均下降 ,减肥后可提高胰岛素敏感性。

To discuss the effect of weight reduction on fat distribution and parameters of insulin sensitivity. Methods 12 Caucasian women with simple obesity,aged 21 to 65 years,were treated by low caloric and high protein diet for four weeks. A series of examinations were taken before and after the treat,using computerized tomography for visceral and subcutaneous fat,using euglycemic insulin clamp for parameters of insulin sensitivity. Results Weight loss was (6±2) kg (2～11 kg).body mass index(BMI),waist,total fat,visceral fat,and subcutaneous fat reduced significantly.However waist-hip rate,visceral-total fat rate,and subcutaneous-total fat rate did not change significantly.Fasting serum insulin,and fasting insulin-glucose rate decreased significantly.Insulin metabolic clearance rate and,insulin sensitive index increased significantly. Fasting peptide C did not change significantly. Conclusions The low caloric and high protein diet can reduce visceral and subcutaneous fat. Weight loss can improve insulin sensitivity and increase insulin metabolic clearance rate.