Long-Lasting Improvements in Liver Fat and Metabolism Despite Body Weight Regain After Dietary Weight Loss
Long-Lasting Improvements in Liver Fat and Metabolism Despite Body Weight Regain After Dietary Weight Loss
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DOI：
10.2337/dc13-0102
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发表时间：
2013-11-01
期刊：
影响因子：
16.2
通讯作者：
Engeli, Stefan
中科院分区：
文献类型：
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作者：
Haufe, Sven;Haas, Verena;Engeli, Stefan
减肥减少腹部和肝内脂肪，从而改善代谢和心血管风险。然而，许多患者在成功的饮食诱导体重减轻后体重恢复。腹部和肝脏脂肪的长期变化，沿着的肝脏检查结果和胰岛素抵抗，是unknown.研究设计和方法我们分析了50名超重到肥胖的受试者（46 9岁; BMI，32.5 - 3.3 kg/m2;女性，77%）谁参加了6个月的低热量饮食，并被随机分配到减少碳水化合物或减少脂肪含量。在节食前、节食后以及平均24个月（范围17-36）的随访中，我们通过磁共振成像和肝功能和胰岛素抵抗的标志物来评估体脂分布。受试者还部分恢复了腹部皮下和内脏脂肪组织。相比之下，肝内脂肪随饮食减少，并在随访时保持减少（7.8 +/- 9.8% [基线]，4.5 +/- 5.9% [6个月]和4.7 +/- 5.9% [随访]）。肝功能、全身胰岛素敏感性和肝脏胰岛素抵抗的标志物也观察到类似的模式。在干预过程中，肝内脂肪和肝内功能的变化是独立的宏量营养素组成，是最有效的非酒精性脂肪肝疾病在baseline.CONCLUSIONSA 6个月的低热量饮食诱导改善肝脏脂肪，肝脏检查结果，和胰岛素抵抗，尽管恢复到2年后，积极干预。体重和肥胖测量可能会低估饮食干预的长期有益影响。
OBJECTIVEWeight loss reduces abdominal and intrahepatic fat, thereby improving metabolic and cardiovascular risk. Yet, many patients regain weight after successful diet-induced weight loss. Long-term changes in abdominal and liver fat, along with liver test results and insulin resistance, are not known.RESEARCH DESIGN AND METHODSWe analyzed 50 overweight to obese subjects (46 9 years of age; BMI, 32.5 3.3 kg/m(2); women, 77%) who had participated in a 6-month hypocaloric diet and were randomized to either reduced carbohydrates or reduced fat content. Before, directly after diet, and at an average of 24 (range, 17-36) months follow-up, we assessed body fat distribution by magnetic resonance imaging and markers of liver function and insulin resistance.RESULTSBody weight decreased with diet but had increased again at follow-up. Subjects also partially regained abdominal subcutaneous and visceral adipose tissue. In contrast, intrahepatic fat decreased with diet and remained reduced at follow-up (7.8 +/- 9.8% [baseline], 4.5 +/- 5.9% [6 months], and 4.7 +/- 5.9% [follow-up]). Similar patterns were observed for markers of liver function, whole-body insulin sensitivity, and hepatic insulin resistance. Changes in intrahepatic fat und intrahepatic function were independent of macronutrient composition during intervention and were most effective in subjects with nonalcoholic fatty liver disease at baseline.CONCLUSIONSA 6-month hypocaloric diet induced improvements in hepatic fat, liver test results, and insulin resistance despite regaining of weight up to 2 years after the active intervention. Body weight and adiposity measurements may underestimate beneficial long-term effects of dietary interventions.