摘要目的 本研究比较低能量均衡饮食和代餐减重对肥胖患者减重依从性、减重幅度、糖脂代谢的影响,以获得可能适合中国肥胖人群个体化的营养减重方案.方法 观察低能量饮食组(n=23)和代餐组(n=17)减重4周及8周后的身高、体重、腰围、体重指数(BMI)、体脂肪、内脏脂肪面积改变,2组减重8周后空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、空腹胰岛素(FINS)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)的变化.结果 低能量及代餐减重均能在4周和8周有效改善身体形态指标,降低体重、腰围、BMI、体脂肪、内脏脂肪面积(P＜0.01),低能量组4周体脂肪(P＜0.01)和身体总水分(P＜0.05)下降更为明显,上述指标8周时2组差别均无明显统计学意义(P＞0.05).在糖脂代谢指标方面,低能量组减重8周后TG、AST、ALT、GGT、ALP、FINS、HOMA-IR明显下降(P＜0.05或P＜0.01),HDL-C升高(P＜0.01).代餐组减重8周后FPG、TG、TC、LDL-C、AST、ALT、ALP、FINS、HOMA-IR明显下降(P＜0.05或P＜0.01).代餐组TC、LDL-C、ALT等指标下降较低能量组更为明显(P＜0.05或P＜0.01).结论 本研究显示低能量及代餐减重有相似的减重效果,但代餐减重对于代谢改善更有优势.

abstractsObjective To investigate the effects of a standard food-based low calorie diet and meal replacements on compliance,weight loss,and glycolipid metabolism in obese patients,and to provide an optimal nutritional weight reduction method for obese individuals in China.Methods Height,weight,waist circumference,body mass index (BMI),body fat,visceral fat in low calorie diet group (n =23) and meal replacements group (n =17) were assessed at baseline,4 and 8 weeks after the intervention.Fasting plasma glucose (FPG),triglyceride (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C),aspartate aminotransferase (AST),alanine transaminase (ALT),gamma-glutamyl transpeptidase (GGT),alkaline phosphatase (ALP),fasting insulin (FINS),and homeostasis model assessment for insulin resistance (HOMA-IR) were assessed at both baseline and 8 weeks after the intervention.Results Both low calorie diet and meal replacements led to significant decreases in body weight,waist circumference,BMI,body fat,and visceral fat(all P＜0.01) after 4 and 8 weeks.Body fat (P＜ 0.01) and total body water (P＜ 0.05) in low calorie diet group were decreased more obviously compared with those in meal replacements group at 4 weeks.However,there were no difference in all these parameters between two groups at 8 weeks (P＞0.05).Both groups experienced improvements in biochemical outcomes and metabolic indicators.TG,AST,ALT,GGT,ALP,FINS,and HOMA-IR levels were all decreased (P＜0.05 or P＜0.01) while HDL-C level was increased (P＜0.01) 8 weeks after standard food-based low calorie diet.FPG,TG,TC,LDL-C,AST,ALT,ALP,FINS,and HOMA-IR levels were declined 8 weeks after meal replacements(P＜0.05 or P＜0.01).TC,LDL-C,and ALT levels were more evidently to reduce in meal replacements group compared with low calorie diet group.Conclusions Present data suggest that meal replacements and low calorie diet may have a similar effect on weight loss,while meal replacements seems to obtain a better metabolic results.