极低碳水化合物饮食干预对肥胖者肺通气功能及代谢指标的影响
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摘要
目的研究极低碳水化合物饮食干预对肥胖者的肺通气功能及相关代谢指标的影响。方法按照体质指数(BMI)和体脂率(PBF)的肥胖标准选取来我院行健康体检的肥胖者,给予极低碳水化合物饮食(VLCD)干预8周,干预前后用相同的方法检测人体成分、肺功能及血清中的相关代谢指标,干预过程中每周进行跟踪随访。观察VLCD的减重效果,分析VLCD对肥胖者肺活量(VC),用力呼气肺活量(FVC),第一秒用力呼气量(FEV_1),第一秒用力呼气量占用力肺活量比值(FEV_1/FVC)等通气功能及总胆固醇(TC),甘油三酯(TG),空腹血糖(FPG)等代谢指标的影响。结果极低碳水化合物饮食干预后,肥胖者的BMI、FBP、WHR与干预前比较均有明显减小,T值分别为12.11、9.73、11.99(P值均<0.01);生化指标TC,LDL-C,FPG跟干预前比较均有明显减小,T值分别为6.11、5.76、6.43(P值均<0.01);TG跟干预前比较均有明显减小,T值为2.15(P值<0.05);HDL-C较干预前增大,T值为-4.91(P值<0.01);肺通气指标VC,FVC,FEV_1,FEV_1/FVC,PEF,FEF25%,FEF75%与干预前比较均有明显升高,T值分别为-8.36、-6.63、-9.63、-3.6、-8.18、-6.29、-3.79。结论 VLCD能显著降低肥胖者的BMI、PBF和WHR,同时有效调节血糖和血脂,改善肺功能损伤,降低肥胖者患糖尿病和心脑血管疾病的风险。
Objective To study the effect of extremely low carbohydrate diet on pulmonary function and biochemical indexes in obese subjects. Methods The obese subjects,who defined by BMI and PBF as described in the first part,were treated with very low carbohydrate diet( VLCD) for 8 weeks. The body composition,pulmonary function and serum biochemical indexes were detected by the same test method,and all subjects were follow-up every week in the process of treatment. The effect of VLCD on weight loss was observed,and the influence of VLCD on pulmonary ventilation indexes( VC,FVC,FEV_1 and FEV_1/FVC) and biochemical indexes( TC,TG and FPG) was analyzed. Results The BMI,FBP and WHR of obese subjects were significant reduced after treated with VLCD. The biochemical indexes of TC,TG,LDL-C and FPG were decreased,and HDL-C was increased when the treatment was completed. Pulmonary ventilation indexes( VC,FVC,FEV_1 and FEV_1/FVC,PEF,FEF25%,FEF75%) had also been improved after treated with VLCD. Conclusion VLCD could significant decrease the BMI,PBF and WHR of obese subjects,and effectively regulate the blood glucose and blood lipid,indicating it can repair the damage of pulmonary function,reduce the risk of suffering from diabetes and cardiovascular and cerebrovascular diseases in obese patients.
Objective To study the effect of extremely low carbohydrate diet on pulmonary function and biochemical indexes in obese subjects. Methods The obese subjects,who defined by BMI and PBF as described in the first part,were treated with very low carbohydrate diet( VLCD) for 8 weeks. The body composition,pulmonary function and serum biochemical indexes were detected by the same test method,and all subjects were follow-up every week in the process of treatment. The effect of VLCD on weight loss was observed,and the influence of VLCD on pulmonary ventilation indexes( VC,FVC,FEV_1 and FEV_1/FVC) and biochemical indexes( TC,TG and FPG) was analyzed. Results The BMI,FBP and WHR of obese subjects were significant reduced after treated with VLCD. The biochemical indexes of TC,TG,LDL-C and FPG were decreased,and HDL-C was increased when the treatment was completed. Pulmonary ventilation indexes( VC,FVC,FEV_1 and FEV_1/FVC,PEF,FEF25%,FEF75%) had also been improved after treated with VLCD. Conclusion VLCD could significant decrease the BMI,PBF and WHR of obese subjects,and effectively regulate the blood glucose and blood lipid,indicating it can repair the damage of pulmonary function,reduce the risk of suffering from diabetes and cardiovascular and cerebrovascular diseases in obese patients.
引文
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[2]Franssen FME.Overweight and obesity are risk factors for COPD misdiagnosis and overtreatment[J].Chest,2014,146(6):1426-1428.
[3]Oda E.Metabolic syndrome:its history,mechanisms,and limitations[J].Acta Diabetol,2012,49(2):89-95.
[4]Mathew R,Castriotta RJ.High hypopnea/apnea ratio(HAR)in extreme obesity[J].J Clin Sleep Med,2014,10(4):391-396.
[5]Yamane T,Yokoyama A,Kitahara Y,et al.Cross-sectional and prospective study of the association between lung function and prediabetes[J].BMJ Open,2013,3(2):e002179.
[6]Harbut P,Gozdzik W,Stjernfalt E,et al.Continuous positive airway pressure/pressure support pre-oxygenation of morbidly obese patients[J].Acta Anaesthesiol Scand,2014,58(6):675-680.
[7]Svendsen PF,Jensen FK,Holst JJ,et al.The effect of a very low calorie diet on insulin sensitivity,beta cell function,insulin clearance,incretin hormone secretion,androgen levels and body composition in obese young women[J].Scand J Clin Lab Invest,2012,72(5):410-419.
[8]王玉玲,姚亚妮,杨新玲.低碳水化合物饮食对肥胖2型糖尿病患者体重和血糖的影响[J].新疆医科大学学报,2009,32(7):914-916.
[9]Kent BD,Grote L,Bonsignore MR,et al.Sleep apnoea severity independently predicts glycaemic health in nondiabetic subjects:the ESADA study[J].Eur Respir J,2014,44(1):130-139.
[10]Saffari M,Pakpour AH,Mohammadi-Zeidi I,et al.Long-term effect of motivational interviewing on dietary intake and weight loss in Iranian obese/overweight women[J].Health Promot Perspect,2014,4(2):206-213.
[11]Scholz K,Kynast AM,Couturier A,et al.Supplementing healthy rats with a high-niacin dose has no effect on muscle fiber distribution and muscle metabolic phenotype[J].Eur J Nutr,2014,53(5):1229-1236.
[12]Das SK,Gilhooly CH,Golden JK,et al.Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence,body composition,and metabolism in CALERIE:a l-y randomized controlled trial[J].Am J Clin Nutr,2007,85(4):1023-1030.