短期限食对代谢综合征患者胃肠激素及脂肪分泌激素的影响  

Effect of short-term caloric restriction on the secretion of gastrointestinal and adipose-derived hormones in patients with metabolic syndrome

作　　者：陈国芳[1] 李春睿[1] 茅晓东[1] 范尧夫[1] 程清[1] 相小多 陈杰[1] 徐书杭[1] 狄红杰[1] 刘克冕[1] 曹萌[1] 刘超[1] 

机构地区：[1]中国中医科学院江苏分院、南京中医药大学附属中西医结合医院内分泌代谢病院区,南京210028

出　　处：《中华内分泌代谢杂志》2015年第3期205-209,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：江苏省科技计划项目（BM2012064）

摘　　要：目的探讨短期极低热量限食对代谢综合征患者胃肠激素及脂肪分泌激素的影响。方法对8例代谢综合征患者行住院9d极低热量限食（300～600kcal／d），测量限食前后体重、腰围、血压；检测限食前后空腹血糖、血脂、胰岛素、胰岛素样生长因子I（IGF-I）、胰淀素、胃促生长素、肠抑胃肽、胰升糖素样肽-1（GLP-1）、瘦素、脂联素水平。结果限食后患者平均体重由（84．46±18．21）kg降至（80．10±17．43）kg（P〈0．01）；腰围减少5cm[（99．88±12．12对95．81±11．82）cm，P〈0．01]；体重指数降低1．5kg／m2[（29．56±4．16对28．03±4．01）kg／m2，P〈0．01]。患者收缩压、舒张压、空腹甘油三酯、血糖、胰岛素以及胰岛素抵抗指数均较限食前明显下降；胆固醇、低密度脂蛋白胆固醇以及高密度脂蛋白胆固醇未见明显差异。IGF—I水平显著下降[（144．50±44．12对108．30±43．01）ng／ml，P=0．00741。胰淀素水平由（35．46±5．99）pg／ml降至（16．23±5．24）ps／ml（P=0．0004）；胃促生长素、肠抑胃肽、GLP-1的变化均无统计学意义；瘦素水平由（12390±2415）pg／ml降至（7191±2083）pg／ml（P=0．0077）；脂联素水平则未见明显变化。结论短期极低热量限食可显著改善代谢综合征患者血糖、血脂、胰岛素抵抗等代谢指标．其机制可能与限食引起的体内能量调节激素的变化有关。Objective To investigate the e＇ffect of short-term severe caloric restriction （SCR） on the secretion of gastrointestinal and adipose-derived hormones in patients with metabolic syndrome. Method Eight patients with metabolic syndrome received SCR for 9 days. Anthropometric and biochemical parameters were determined before and after SCR. Results After short-term SCR, the average body weight was decreased from （84. 46 ± 18.21 ） kg to （ 80.10 ± 17.43 ） kg （ P〈0.01 ）, waist circumference reduced from （ 99.88± 12.12 ） cm to （ 95.81±11.82 ） cm （ P〈 0. 01 ）, and body mass index decreased from （29.56 ±4.16 ） kg/m2 to （ 28.03 ±4.01 ） kg/m2 （ P〈0.01 ）. Blood pressure, fasting triglycerides, fasting blood glucose, fasting insulin, and homeostasis model assessment for insulin resistance were all reduced significantly after SCR, while no differences were found in serum cholesterol, low density lipoprotein-cholesterol, and high density lipoprotein-cholesterol. The level of insulin-like growth factor- I （ IGF- I ） was decreased from （ 144.50 ± 44.12 ） ng/ml to （ 108.30± 43.01 ） ng/ml （ P = 0.007 4 ）. Among hormones related to energy regulation, the levels of amylin and leptin were reduced from （ 35.46 ± 5.99 ） pg/ml to （ 16.23 ± 5.24 ） pg/ml （P=0. 000 4） and from （12 390± 2 415） pg/ml to （7 191 ±2 083） pg/ml （P=0. 007 7） after SCR, respectively. However, there was no significant difference in ghrelin, gastric inhibitory polypeptide, GLP-1, and adiponectin before and after SCR. Conclusions Short-term SCR improved metabolic markers in patients with metabolic syndrome. The changes in hormones related to energy regulation induced by SCR could be involved in the mechanism.

关 键 词：限食 代谢综合征 胃肠激素 脂肪来源激素 

分 类 号：R589[医药卫生—内分泌]