Effects of diet-induced moderate weight reduction on intrahepatic and intramyocellular triglycerides and glucose metabolism in obese subjects
Effects of diet-induced moderate weight reduction on intrahepatic and intramyocellular triglycerides and glucose metabolism in obese subjects
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DOI：
10.1210/jc.2006-2384
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发表时间：
2007-08-01
影响因子：
5.8
通讯作者：
Kawamori, Ryuzo
中科院分区：
文献类型：
--
作者：
Sato, Fumihiko;Tamura, Yoshifumi;Kawamori, Ryuzo
背景：虽然适度减肥被推荐为代谢综合征的主要治疗方法，但关于非糖尿病肥胖者适度减肥相关的代谢变化的信息知之甚少。目的：本研究的目的是确定适度减肥计划对肌肉和肝脏细胞内脂肪和葡萄糖代谢的影响。参与者：评估了13名非糖尿病肥胖者的数据。干预：受试者接受为期3个月的轻度低热量饮食治疗(类似于35千卡/公斤的理想体重)。主要观察指标：使用H-1磁共振波谱测量肝脏内脂肪(IHL)和心肌细胞内脂肪。结果：饮食治疗3个月后体重下降6%，体重由99.9+/-7.3g降至93.8+/-6.6kgP<；0.0001。伴随这一变化的是75g口服葡萄糖耐量试验中血糖和胰岛素漂移的减少，舒张压、糖化血红蛋白、血清低密度脂蛋白胆固醇和甘油三酯的下降。这些变化还伴随着IHL的下降(从12.9%下降到8.2%，P<；0.01)和内脏葡萄糖摄取量的增加(从13.5%增加到35.0%，P<；0.03)。另一方面，饮食方案不影响正常血糖高胰岛素钳夹期间心肌细胞内脂质或葡萄糖的输注速度。结论：我们的结果表明，肥胖受试者适度的体重减轻降低了IHL，增加了内脏葡萄糖摄取。这一机制至少部分涉及通过适度减轻肥胖受试者的体重来改善葡萄糖代谢。
Context: Although moderate weight reduction is recommended as primary therapy of metabolic syndrome, little information is known regarding metabolic changes associated with moderate weight reduction in nondiabetic obese subjects.Objective: The aim of this study was to determine the effects of a moderate weight reduction program on intracellular lipid and glucose metabolism in muscle and liver.Participants: Data for 13 nondiabetic obese subjects were evaluated.Intervention: Subjects were put on a 3-month mildly hypocaloric diet therapy (similar to 35 kcal/kg of ideal body weight).Main Outcome Measures: Intrahepatic lipid (IHL) and intramyocellular lipid were measured by using H-1 magnetic resonance spectroscopy. Peripheral insulin sensitivity and splanchnic glucose uptake were evaluated by euglycemic-hyperinsulinemic clamp with oral glucose load.Results: Diet therapy for 3 months resulted in 6% reduction in body weight (from 99.9 +/- 7.3 to 93.8 +/- 6.6 kg, P < 0.0001). This change was accompanied by reduction of plasma glucose and insulin excursions during 75-g oral glucose tolerance tests, decrease in diastolic blood pressure, glycated hemoglobin, serum low-density lipoprotein cholesterol, and triglyceride. These changes were also accompanied by a decrease in IHL (from 12.9 to 8.2%, P < 0.01) and increase in splanchnic glucose uptake (from 13.5 to 35.0%, P < 0.03). On the other hand, the diet program did not affect intramyocellular lipid or glucose infusion rate during euglycemic hyperinsulinemic clamp.Conclusions: Our results suggest that moderate weight reduction in obese subjects decreased IHL and augmented splanchnic glucose uptake. This mechanism is at least in part involved in improvement of glucose metabolism by moderate weight reduction in obese subjects.