极低碳水化合物饮食对肥胖症患者心血管危险因素的影响  

The effects of a very low carbohydrate diet intervention on improving cardiovascular risk factors in obese subjects

作　　者：顾云娟[1] 崔世维[1] 于浩泳[2] 胡承[2] 陆俊茜[2] 马晓静[2] 包玉倩[2] 贾伟平[2] 

机构地区：[1]南通大学附属医院内分泌科,226001 [2]上海交通大学附属第六人民医院内分泌科上海市糖尿病重点实验室上海市糖尿病研究所上海市糖尿病临床医学中心

出　　处：《中华内科杂志》2014年第1期9-12,共4页Chinese Journal of Internal Medicine

基　　金：国家重点基础研究发展计划（2011CB504001）;卫生行业科研专项项目（201002002）;科技重大专项项目-重大新药创制（2011zx09307-001-02）;肥胖相关基因与中国成人体脂分布及腹型肥胖的关系（12QH1401700）

摘　　要：目的 观察极低碳水化合物饮食（VLCD）治疗对单纯性肥胖患者心血管危险因素的影响.方法 观察35例肥胖患者经VLCD治疗8周后,体重、腰围及血压改善的同时,空腹血糖（FPG）、空腹胰岛素（FIns）、血脂谱、尿微量白蛋白/肌酐（UACR）、C反应蛋白（CRP）、TNFα、脂联素（adiponectin）等心血管危险因素的改变.另采集35例健康志愿者作为基线对照组.结果 基线时肥胖组较正常对照组有更显著的心血管危险因素（P值均＜0.05）.试验结束时肥胖患者的体重与腰围分别减少了（8.5 ±0.7）kg与（6.6±1.1）cm（P值均＜0.01）;收缩压、舒张压、FIns、TC、TG等指标均较前显著降低（P值均＜0.05）;FPG、LDL-C及HDL-C等的改变无统计学意义;UACR、CRP、TNFα分别减少了（1.86 ±0.86） μg/mg、（1.15 ±0.45） mg/L及（0.94 ±0.21）ng/L（P值均＜0.05）;脂联素水平增加了（2.12 ±0.59）mg/L（P ＜0.01）.结论 8周的VLCD治疗肥胖症可有效减重并显著改善多种心血管危险因素.Objective To investigate the effects of a very low carbohydrate diet （VLCD） on improving cardiovascular risk factors in obese individuals.Methods A 8-week VLCD was given to 35 healthy obese subjects and the control group was consisted of 35 healthy volunteers.Multi-cardiovascular risk factors were investigated,including weight,waist circumference,BMI,blood pressure,fasting plasma glucose （FPG）,fasting insulin （FIns）,lipid profiles,urinary albumin-creatinine ratio （UACR）,C-reactive protein（CRP）,TNFα and adiponectin.Results At the baseline of the study,compared with the healthy control group,all the cardiovascular risk factors were significantly more deteriorated in the obese subjects （all P values 〈 0.05）.At the end of the study,the obese subjects showed significant decrease in their mean weight and waist circumference [（8.5 ± 0.7） kg and （6.6 ± 1.1） cm,respectively; all P values 〈 0.01].Significant decrease was also found in the levels of systolic blood pressure （SBP）,diastolic blood pressure （DBP）,FIns,TC and TG （all P values 〈 0.05）,while no significant change of FPG,HDL-C and LDL-C.The levels of UACR,CRP and TNFα were all significantly decreased [（1.86 ± 0.86） μg/mg,（1.15 ± 0.45） mg/L and （0.94 ± 0.21） ng/L,respectively; all P values 〈 0.05],while the level of adiponectin was significantly increased [（2.12 ± 0.59） mg/L,P 〈 0.01].Conclusion VLCD is an effective intervention in obese subjects which could improve the cardiovascular risk factors by the modest weight loss.

关 键 词：肥胖症 膳食 低碳水化合物 心血管疾病 危险因素 

分 类 号：R589.2[医药卫生—内分泌]