摘要
目的:探讨减重干预对肥胖伴内皮功能障碍者转归的影响。方法:对伴有内皮功能障碍的207例单纯肥胖者进行为期24个月的强化生活方式减重干预,干预前后分别测定血管内皮功能和各项代谢指标。结果:减重达标组122例中内皮依赖性血管舒张功能(EDD)转为正常者49例(40.2%),未达标组74例中12例EDD转为正常(16.2%),两组比较,差异有显著性(χ2=12.323,P<0.01)。未达标组基线时空腹胰岛素水平及胰岛素抵抗指数(HOMA-IR)显著高于达标组(P<0.05和P<0.01)。减重干预24个月后与干预前比较,达标组体重指数(BMI)、腰围、腰臀比、收缩压、舒张压、总胆固醇、甘油三酯、血糖及HOMA-IR均显著降低(P<0.05或0.01),EDD显著升高(P<0.01);未达标组BMI、腰围、腰臀比、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖及HOMA-IR无明显差异,而收缩压、舒张压、总胆固醇、空腹胰岛素较前降低(P<0.05或0.01),EDD较前升高,但降低或升高程度低于达标组。结论:减重干预可逆转肥胖相关的内皮功能障碍和代谢异常。
Objective To explore the effect of weight loss intervention on the outcomes in obese subjects with endothelial dysfunction. Methods 207 obese subjects （BMI ≥ 25 kg/m^2） received a 24-month, intensified lifestyle intervention for weight reduction. Before and after invention, flow-mediated endothelium-dependent dilatation （EDD） and other metabolic parameters were measured. Results The rate of EDD recovery differed significantly between the group with achievement of standard weigh-loss （ASWL） and the group with failure of weigh-loss achievement （FWLA） （40.2% vs 16.2%; χ^2 = 12.323, P〈 0.01）. Fasting insulin and insulin resistance index （HOMA-IR） in baseline levels were higher in the FWLA group than the ASWL group （P 〈 0.05 and P 〈 0.01）. After 24-month invention, waist circumference, waist-hip ratio, blood pressure, total cholesterol, triglyceride, fasting plasma glucose, and HOMA-IR were significantly decreased （P 〈 0.05 or P 〈 0.01 ） and EDD was increased （P 〈 0.01 ） in the ASWL group; while only blood pressure, triglyceride, and fasting insulin were declined and EDD was increased （P 〈 0.05 or P 〈 0.01 ） in the FWLA group, with lesser change as compared with the ASWL group. Conclusion Weight loss intervention can reverse endothelial dysfunction and improve metabolic parameters in obese subjects.
出处
《实用医学杂志》
CAS
北大核心
2009年第13期2077-2079,共3页
The Journal of Practical Medicine
关键词
肥胖症
减重
血管内皮功能
干预性研究
Obesity
Weight toss
Endothelial function
Intervention studies
