Lean mass in obese adult subjects correlates with higher levels of vitamin D, insulin sensitivity and lower inflammation
Lean mass in obese adult subjects correlates with higher levels of vitamin D, insulin sensitivity and lower inflammation
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DOI：
10.1007/s40618-014-0189-z
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发表时间：
2015-03-01
影响因子：
5.4
通讯作者：
Migliaccio, S.
中科院分区：
文献类型：
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作者：
Fornari, R.;Francomano, D.;Migliaccio, S.
目的肥胖患者存在几种慢性代谢改变。众所周知，腹部脂肪组织对慢性代谢临床状况的不利影响，但对肥胖受试者中瘦质量的作用知之甚少。因此，我们研究的目的是评估肥胖个体的肌肉质量、代谢状况和炎症状态之间的潜在相关性。方法纳入426例肥胖患者，其中男性86例，女性340例，平均年龄44.8 +/- 14岁，BMI 34.9 +/- 6.1 kg/m(2)。排除标准是慢性疾病或使用影响骨代谢的药物，激素和营养状况的改变，维生素D的补充，最近的体重减轻和以前的减肥手术。通过双x线吸收仪测量患者的骨密度（腰椎和髋关节）和身体组成（瘦质量，总脂肪量和躯干脂肪量），并评估激素和代谢谱以及炎症标志物。结果较高的瘦体重（LM%）与胰岛素抵抗的稳态模型评估呈负相关（p < 0.0091; r(2) 0.03938），与较低的纤维蛋白原水平相关（p < 0.0001; r(2) 0.1263）。有趣的是，在肥胖受试者中，LM%与较高水平的维生素D （p < 0.0001, r(2) 0.1140）、骨钙素（p < 0.0001, r(2) 0.2401）和胰岛素样生长因子-1 （p < 0.0002, r(2) 0.1367）相关。我们的研究结果首次表明，在肥胖患者中，较高的瘦质量与较低的炎症特征和更好的胰岛素敏感性直接相关，但也与较高水平的维生素D和IGF-1存在直接相关。此外，这些数据表明，肥胖者的瘦体重水平越高，代谢状况越好，因此，强烈建议有必要制定计划，促进肥胖者增加体育活动。
Aim Several chronic metabolic alterations are present in obese subjects. While it is well known about the detrimental effect of abdominal adipose tissue on chronic metabolic clinical condition, less is known on the role of lean mass in obese subjects. Thus, the aim of our study was to evaluate the potential correlation of muscle mass, metabolic condition and inflammation status in obese individuals.Methods The study included 426 obese subjects (86 men and 340 female; mean age 44.8 +/- 14 years; BMI: 34.9 +/- 6.1 kg/m(2)). Exclusion criteria were chronic medical conditions or use of medications affecting bone metabolism, alterations of hormonal and nutritional status, vitamin D supplementation, recent weight loss and prior bariatric surgery. Patients underwent measurements of bone mineral density (lumbar and hip) and body composition (lean mass, total and trunk fat mass) by dual X-ray absorptiometry and were evaluated for hormonal and metabolic profile and inflammatory markers.Results Higher lean body mass (LM%) was inversely correlated with homeostasis model assessment of insulin resistance (p < 0.0091; r(2) 0.03938) and associated with lower fibrinogen levels (p < 0.0001; r(2) 0.1263). Interestingly, in obese subjects, LM% was associated with higher levels of vitamin D (p < 0.0001, r(2) 0.1140), osteocalcin (p < 0.0001, r(2) 0.2401) and insulin-like growth factor-1 (IGF-1) (p < 0.0002, r(2) 0.1367).Conclusion Our results show for the first time that in obese patients, higher amounts of lean mass are directly linked to a lower inflammatory profile and to better insulin sensitivity, but also to the presence of higher level of vitamin D and IGF-1. Moreover, these data suggest that higher levels of lean mass in obese people correlate with a better metabolic profile and, thus, strongly suggest the need to develop programs to facilitate an increase in physical activity in obese people.