Effects of weight loss on regional fat distribution and insulin sensitivity in obesity
Effects of weight loss on regional fat distribution and insulin sensitivity in obesity
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DOI：
10.2337/diabetes.48.4.839
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发表时间：
1999-04-01
期刊：
影响因子：
7.7
通讯作者：
Thaete, FL
中科院分区：
文献类型：
--
作者：
Goodpaster, BH;Kelley, DE;Thaete, FL
减肥（WL）减少脂肪组织的区域储存和改善胰岛素敏感性，这两个参数在WL之前是相关的。为了研究WL引起的局部肥胖变化与胰岛素敏感性改善的潜在关系，32名肥胖的久坐不动的女性和男性完成了4个月的WL计划，并重复测定了身体成分（双能x线吸收仪和计算机断层扫描）和胰岛素敏感性（正糖胰岛素输注）。有15名瘦弱的男性和女性作为控制对象。Vo（2max）与WL (39.2 +/- 0.8 vs. 39.8 +/- 1.1 ml.脱脂质量[FFM]（-1).min(-1)）不变。WL干预显著降低了体重（100.2 +/- 2.6至85.5 +/- 2.1 kg）、BMI（34.3 +/- 0.6至29.3 +/- 0.6 kg/m(2)）、总脂肪质量（FM）（36.9 +/- 1.5至26.1 +/- 1.3 kg）、体脂百分比（37.7 +/- 1.3至31.0 +/- 1.5%）和FFM（59.2 +/- 2.3至55.8 +/- 2.0 kg）。腹部皮下和内脏脂肪组织（SAT和VAT）减少(分别为494 +/- 19至357 +/- 18 cm（2)和157 +/- 12至96 +/- 7 cm(2)）。WL后，大腿中部低密度肌（LDM）横截面积从67 +/- 5减少到55 +/- 4 cm(2)，胰岛素敏感性从5.9 +/- 0.4提高到7.3 +/- 0.5 mg。min（-1）与WL。胰岛素刺激的非氧化性葡萄糖处理率占了这种改善的大部分(3.00 +/- 0.3 to。4.3 +/- 0.4 mg。分钟(1))。WL后血清瘦素、甘油三酯、胆固醇、胰岛素均降低（P < 0.01）。WL后，胰岛素敏感性继续与全身和局部肥胖相关，但除了VAT百分比下降外，胰岛素敏感性改善的幅度不能通过身体成分的各种变化来预测。这些介入性减肥数据强调了内脏脂肪与胰岛素抵抗相关的潜在重要性，否则表明超过一定的体重减轻阈值，胰岛素敏感性的改善与体重减轻的程度没有线性关系。
Weight loss (WL) decreases regional depots of adipose tissue and improves insulin sensitivity, two parameters that correlate before WL. To examine the potential relation of WL-induced change in regional adiposity to improvement in insulin sensitivity, 32 obese sedentary women and men completed a 4-month WL program and had repeat determinations of body composition (dual-energy X-ray absorptiometry and computed tomography) and insulin sensitivity (euglycemic insulin infusion). There were 15 lean men and women who served as control subjects. Vo(2max) was unaltered with WL (39.2 +/- 0.8 vs. 39.8 +/- 1.1 ml.fat-free mass [FFM](-1).min(-1)). The WL intervention achieved significant decreases in weight (100.2 +/- 2.6 to 85.5 +/- 2.1 kg), BMI(34.3 +/- 0.6 to 29.3 +/- 0.6 kg/m(2)), total fat mass (FM) (36.9 +/- 1.5 to 26.1 +/- 1.3 kg), percent body fat (37.7 +/- 1.3 to 31.0 +/- 1.5%), and FFM (59.2 +/- 2.3 to 55.8 +/- 2.0 kg). Abdominal subcutaneous and visceral adipose tissue (SAT and VAT) were reduced (494 +/- 19 to 357 +/- 18 cm(2) and 157 +/- 12 to 96 +/- 7 cm(2), respectively). Cross-sectional area of low-density muscle (LDM) at the mid-thigh decreased from 67 +/- 5 to 55 +/- 4 cm(2) after WL, Insulin sensitivity improved from 5.9 +/- 0.4 to 7.3 +/- 0.5 mg.FFM-1.min(-1) with WL. Rates of insulin-stimulated nonoxidative glucose disposal accounted for the majority of this improvement (3.00 +/- 0.3 to. 4.3 +/- 0.4 mg.FFM-1. min(-1)). Serum leptin, triglycerides, cholesterol, and insulin all decreased after WL (P < 0.01). After WL, insulin sensitivity continued to correlate with generalized and regional adiposity but, with the exception of the percent decrease in VAT, the magnitude of improvement in insulin sensitivity was not predicted by the various changes in body composition. These interventional weight loss data underscore the potential importance of visceral adiposity in relation to insulin resistance and otherwise suggest that above a certain threshold of weight loss, improvement in insulin sensitivity does not bear a linear relationship to the magnitude of weight loss.