EVALUATION OF WEIGHT CHARTING AND HUMORAL FACTORS AFFECTING EATING AND SATIETORY CENTERS IN OBESE SUBJECTS

大多数关于肥胖受试者体重减轻的研究未能维持数年的体重减轻，并且所谓的反弹现象的机制尚未完全了解。本文报告了每日体重模式图作为减肥辅助手段的有效性。我们对1995年至1997年间参加我们减肥计划的135名女性患者进行了疗效评估。减肥计划开始时的平均年龄和BMI为48.2（± SD）。[)0.7（平均值（）SY. ±. [)SE)和29.2（]SY. [)0.2（kg/m2）。要求所有肥胖受试者记录他们2年的每日体重。本研究测定了3-羟丁酸（3-hydroxybutyric acid，3 HB）和瘦素（leptin）两种体液因子在减肥前后的变化。在减肥过程中，34%的肥胖受试者体重下降超过初始体重的5%（A组），但其余肥胖受试者体重未能下降（B组）。我们将体重制图的完成程度评价为从0（未制图）到100（完美）的评分，并将A组（71.2（± 1.5）分）之间的平均评分进行比较。[）2.5）和B（42.9（]SY. ±. [2.7]。A组与B组比较差异有统计学意义（P<0.001）。体重指数与瘦素水平的相关性无论在减肥过程中还是在体重反弹现象中均非常显著（P<0.001），提示瘦素抵抗。而体重指数与3 HB无相关性，减肥后3 HB增加了1.5M。结果提示，每日体重模式图是减肥的有效辅助手段，血瘦素水平反映了脂肪组织的数量。

Most of the studies on weight reduction in obese subjects failed to maintain thier weight loss for several years and mechanisms of the so-called rebound phenomenon are not fully understood. The efeicacy of charting of daily weight pattern as an aid towaed weight reduction was reported. We evaluated its efficacy in 135 pbese femaled who were admitted to our weight reduction program between 1995 and 1997. Average age and BMI at the beginning of weight reduction program were 48.2(]SY.+-。[)0.7 (mean(]SY.+-。[)SE), and 29.2(]SY.+-。[)0.2 (kg/m2) respectively. All obese subjects are requested to chart their daily weight for 2 years. Two humoral factors, 3-hydroxybutyric acid (3HB) and leptin, released from adipose tissues into the blood affecting a feeding and a satietory center in the brain, were measured before and after weight reduction program which includes nutrition, expercise and behavioral treatment for 3.5monthes. During the weight reduction progra, 34% lost their more than 5% of their initial weight (group A), but the remaining obese subjects failed to loose weight (group B). We evaluated the degree of completion in weight charting as a score from 0 (no charting) to 100 (perfect) and the mean of the score was compared between group A (71.2(]SY.+-。[)2.5) and B (42.9(]SY.+-。[)2.7). The difference between group A and B was statistically significant (P<0.001). The correlation between BMI and leptin level was consistently high (P<0.001) in not only during weight reduction but also rebound phenomenon, sugesting leptin resistance. But, such correlation was not found between 3HB and BMI,while 3HB increased 1.5 M After weight reduction program. These results suggest that charting of daily weight pattern is effective aid for weight reduction and blood leptin level refrects the amount of fat tissuies.