Abdominal obesity: causal factor or simply a symptom of obesity-related health risk.
Abdominal obesity: causal factor or simply a symptom of obesity-related health risk.
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DOI：
10.2147/dmso.s64546
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Shoda J
中科院分区：
文献类型：
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作者：
Oh S;Tanaka K;Noh JW;So R;Tsujimoto T;Sasai H;Kim M;Shoda J
提倡减少腹部脂肪（AF）来治疗肥胖相关疾病。尽管如此，最近的研究表明，与减少房颤无关，对肥胖相关的健康风险也有额外的有益作用。因此，确定房颤是否在促进代谢紊乱中发挥因果作用，或者仅仅是肥胖相关健康危险因素增加的症状非常重要。阐明 AF 在肥胖相关疾病发病机制中的主要作用也很重要。这项回顾性研究的目的是：1) 比较因不同治疗（运动和饮食限制）而表现出等量房颤消失的各组之间肥胖相关健康风险因素的改善程度；2) 确定接受相同治疗（运动）但房颤减少方面表现出显着差异的受试者中肥胖相关健康风险结果的明确差异。在完成 12 周运动或饮食限制计划的 66 名受试者中，17 个参数（收缩压 [SBP] 和舒张压 [DBP]；高敏 C 反应蛋白 [hs-CRP]；瘦素、脂联素、肿瘤坏死因子 [TNF]-α、白细胞介素 [IL]-6；丙氨酸氨基转移酶 [ALT]、γ 谷氨酰转肽酶[γGT]；血脂谱：高密度脂蛋白胆固醇[HDLC]、甘油三酯[TG]、空腹血糖[FPG]、糖化血红蛋白[HbA1c]、胰岛素抵抗稳态模型评估（HOMA-IR）；肌酐、尿酸和最大有氧代谢能力[VO2 max]）作为肥胖相关健康风险的指标。尽管运动组和饮食限制组（目标 1）的 AF 降低程度相当（-29.5% 与 -30.1%），但 10 个参数（SBP、DBP、HDLC、HOMA-IR、尿酸、肌酐、hs-CRP、脂联素、IL-6 和 VO2 max）显示出显着差异。然而，对于同一运动计划（目标 2）中各组受试者之间较大的 AF 减少差异（-30.1% 与 -2.8%），只有肌酐和最大摄氧量不同。单独减少房颤可能与肥胖相关健康危险因素的改善没有直接关系，这表明需要重新审查减少房颤的管理（即改变生活方式），而不是简单地以减少房颤为目标。
Abdominal fat (AF) reduction is advocated in the treatment of obesity-related diseases. Nonetheless, recent studies have shown additional beneficial effects against obesity-related health risks, independent of AF reduction. Therefore it is important to determine whether AF plays a causal role in promoting metabolic disorders or is simply a symptom of increased obesity-related health risk factors. Clarification of the primary role of AF in the pathogenesis of obesity-related disease is also important. This retrospective study was conducted with the objectives of 1) comparison between groups exhibiting equivalent amounts of AF loss that resulted from distinct treatments (exercise and dietary restriction) with respect to degrees of improvement in obesity-related health risk factors and 2) determination of definite differences in the outcomes of obesity-related health risk in subjects receiving identical treatment (exercise) but exhibiting a remarkable difference in AF reduction. In 66 subjects who completed a 12-week exercise or dietary restriction program, 17 parameters (systolic blood pressure [SBP] and diastolic blood pressure [DBP]; high-sensitivity C-reactive protein [hs-CRP]; leptin, adiponectin, tumor necrosis factor [TNF]-α, interleukin [IL]-6; alanine aminotransferase [ALT], gamma glutamyl transpeptidase [γGT]; lipid profile: high-density lipoprotein cholesterol [HDLC], triglyceride [TG]; fasting plasma glucose [FPG], hemoglobin A1c [HbA1c], homeostasis model assessment of insulin resistance (HOMA-IR); creatinine, uric acid; and maximal aerobic capacity [VO2 max]) were examined as indicators of obesity-related health risk. Despite equivalent magnitudes of AF reduction (−29.5% versus −30.1%) in subjects in the exercise and dietary restriction groups (objective 1), ten parameters (SBP, DBP, HDLC, HOMA-IR, uric acid, creatinine, hs-CRP, adiponectin, IL-6, and VO2 max) showed significant differences. However, for large AF reduction differences (−30.1% versus −2.8%) between groups of subjects in the same exercise program (objective 2), only creatinine and VO2 max were different. It is likely that AF reduction alone is not directly linked to improvement in obesity-related health risk factors, indicating the need for reexamination of the management for AF reduction (ie, lifestyle modification) rather than simply targeting reduction of AF.