Factors involved in body weight loss and its maintenance in morbidly obese inpatients
Factors involved in body weight loss and its maintenance in morbidly obese inpatients
复制标题
DOI：
10.1007/s13340-019-00403-y
复制
发表时间：
2020-01-01
影响因子：
2.2
通讯作者：
Nagasaka, Shoichiro
中科院分区：
文献类型：
--
作者：
Tadokoro, Rie;Iida, Tatsuya;Nagasaka, Shoichiro
背景肥胖患者的体重减轻可改善糖耐量异常、血脂异常和高血压；然而，这种体重减轻很难维持。这项研究的目的是检查与病态肥胖住院患者体重减轻及其维持有关的因素。方法研究对象为31例肥胖患者，男11例，女20例。对入院时和出院后体重变化的相关因素进行回顾性分析。平均年龄58.1±13.6岁，体重指数40.2±10.2 kg/m(2)。合并2型糖尿病24例。饮食治疗为23.8+/-3.9kcal/kg理想体重/天。结果住院期间超额减重(EWL)为4.2%~61.7%。由于EWL受住院时间的影响，受试者被除以每天EWL的中位数。全身组(n=31)、糖尿病组(n=24)和非糖尿病组(n=7)入院时体重、BMI和脂肪含量均低于对照组。糖尿病和非糖尿病受试者之间每天的EWL没有差异。随访数据显示，BMI在出院3个月后保持不变，但在出院1年后略有增加，与住院期间每天的EWL无关。糖尿病患者出院后1年随访(n=15)，体重增加小于非糖尿病患者(n=3)。结论病态肥胖住院患者的EWL大于基线BMI和脂肪量较低的患者。住院期间糖尿病的存在对EWL无影响。住院期间EWL与出院后EWL的维持无关。糖尿病患者出院后体重增加程度较轻，可能是由于抗糖尿病药物的影响。
Background Body weight loss in patients with obesity improves abnormal glucose tolerance, dyslipidemia and hypertension; however, it is difficult to maintain this loss of body weight. The objective of this study was to examine factors involved in body weight loss and its maintenance in morbidly obese inpatients. Method The subjects were 31 patients (11 males and 20 females) who were admitted to hospital for obesity management. Factors involved in body weight changes during hospitalization and after discharge were examined retrospectively. The mean age was 58.1 +/- 13.6 years and body mass index (BMI) was 40.2 +/- 10.2 kg/m(2). Twenty-four patients were complicated with type 2 diabetes mellitus. Diet therapy was 23.8 +/- 3.9 kcal/kg ideal body weight/day. Results Excess weight loss (EWL) during hospitalization varied from 4.2 to 61.7%. Since EWL was affected by duration of hospital stay, the subjects were divided by the median of EWL per day. The subjects with greater EWL per day had lower body weight, BMI and fat mass on admission in the entire (n = 31), diabetic (n = 24), and non-diabetic subjects (n = 7), respectively. EWL per day was not different between diabetic and non-diabetic subjects. Follow-up data revealed that BMI remained unchanged 3 months after discharge but modestly increased 1 year after discharge, irrespective of EWL per day during hospitalization. In diabetic subjects followed up 1 year after discharge (n = 15), the increase in body weight was smaller than that in non-diabetic subjects (n = 3). Conclusion These results suggest that EWL in morbidly obese inpatients is greater than those with lower baseline BMI and fat mass. The presence of diabetes had no effects on EWL during hospitalization. EWL during hospitalization was not correlated with its maintenance after discharge. Diabetic patients displayed lesser degree of body weight gain after discharge, possibly due to the effects of anti-diabetic medications.