消化性体质性肥胖患者发生代谢紊乱的风险

M. B. Lyasnikova, N. Belyakova, I. Tsvetkova, A. Rodionov, N. Milaya
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引用次数: 0

摘要

背景:消化性体质性肥胖由于其高患病率,是现代医疗系统的关键问题。然而,肥胖并不总是伴随着代谢紊乱,导致早期致残和死亡。这就是为什么研究肥胖患者代谢不健康的风险很重要。目的:探讨增加消化性体质性肥胖患者代谢失衡风险的因素。材料和方法:对消化性体质性肥胖患者进行检查,包括人体测量(体重指数、腰围、臀围、腰臀比)、血压测量、实验室测试——代谢指标:葡萄糖、胰岛素、胰岛素抵抗指数、瘦素、胆固醇、脂蛋白胆固醇、甘油三酯,天冬氨酸氨基转移酶、丙氨酸氨基转移酶和γ-谷氨酰胺转移酶),通过生物电阻抗分析进行身体成分测量;患者还就他们的行为(饮食习惯)和体育活动进行了访谈。结果:根据代谢健康指标分为两组:主要组-代谢性非健康肥胖(MNHO)-241人(年龄41±12,09,肥胖持续时间12,5±9,51年),伴有消化性体质性肥胖和两种或两种以上MS症状,代谢健康肥胖(MHO)的对照组——120人(年龄35,5±10.03;p<0.05,肥胖持续时间8,0±7,39年;p<0,05)患有消化性体质性肥胖和一种MS症状或无MS症状。对代谢性非健康饮食性体质性肥胖发生的危险因素进行的数据分析证实,MNHO发生的最相关因素是腹部脂肪量分布(女性腰围增加超过88 sm,邮件腰围增加超过102 sm)。MNHO不仅与MS的典型体征有关,还与血胰岛素水平、胰岛素抵抗指数、脂肪代谢失衡和肝功能紊乱有关。出现代谢紊乱的风险更大的是45岁以上的患者,其活动细胞质量下降(低于45%),肥胖持续时间超过10年,遗传性肥胖负担沉重。在饮食习惯方面,摄入高脂乳食物会增加代谢性非健康肥胖的风险,相反,经常吃零食、不含酒精的甜饮料并没有影响代谢性非肥胖。结论:MNHO的发生不仅与患者年龄、肥胖持续时间、碳水化合物和脂肪代谢指标有关,而且代谢活性组织的百分比降低以及一些饮食习惯。
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Risks for development of metabolic disorders in alimentary constitutional obesity
BACKGROUND: alimentary-constitutional obesity due to it’s high prevalence, is the key problem of modern healthcare system. However, obesity is not always accompanied with metabolic disorders, leading to early invalidization and mortality. That’s why it is important to study risks of metabolical nonhealth in obesity.AIM: to detect factors, increasing risks of development of metabolic disbalance in alimentary-constitutional obesity.MATERIALS AND METHODS: In patients with alimentary-constitutional obesity there was performed an examination including anthropometry (body mass index, Waist Circumference, Hip Circumference,waist to hip ratio), blood pressure measurement, laboratory tests – metabolic indexes: glucose, insulin, insulin resistance indexes, leptin, cholesterol, cholesterol of lipoproteins, triglycerides, aspartate aminotransferase, alanine aminotransferase, gamma-glutamiltransferase), body composition measurement by bioelectrical impedance analysis; patients were also interviewed on their behavior (food habits) and physical activity.RESULTS: There were formed two groups depending on metabolic health indexes: main group – metabolically non-healthy obesity (MNHO) - 241 persons (aged 41±12,09, duration of obesity 12,5±9,51 years) with alimentary-constitutional obesity and two or more signs of MS, a comparison group – of metabolically healthy obesity (MHO) – 120 persons (aged 35,5±10,03; p<0,05, duration of obesity 8,0±7,39 years; p<0,05) with alimentary-constitutional obesity and one sign of MS or without it. Data analysis of studied risk factors for development of metabolically non-healthy alimentary-constitutional obesity confirmed that most relevant factor in development of MNHO is abdominal fat mass distribution (increasing of Waist Circumference over 88 sm in females and over 102 sm in mails). At the same time MNHO had correlation not only with classical signs of MS, but also with blood insulin level, insulin resistance indexes, fat metabolism disbalance and liver disfunction. More severed risk for appearance of metabolic disorders have patients over 45 years old with decreased active cell mass (less than 45%), duration of obesity above 10 years and obesity-burdened heredity. In food habits risk of development of metabolically non-healthy obesity was increased in taking of fat milk food, and, on the contrary, - frequent snacks, alcohol free sweet drinks didn’t affect it.CONCLUSION: Development of MNHO is associated not only with the age of patient, duration of obesity, carbohydrate and fat metabolism indexes, but also with decreased percentage of metabolically active tissues and some food habits.
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Obesity and Metabolism-Milan
Obesity and Metabolism-Milan 医学-内分泌学与代谢
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