短期VLCD干预对超重肥胖患者骨代谢影响的研究

2016-11-01郑和昕赵小红

浙江医学教育 2016年1期

关键词：研究

林晨，郑和昕，张微，单晶，赵小红，王霞

(浙江医院，浙江杭州 310013)

·基础与临床研究·

短期VLCD干预对超重肥胖患者骨代谢影响的研究

林晨，郑和昕，张微，单晶，赵小红，王霞

(浙江医院，浙江杭州 310013)

目的：探讨短期极低碳水化合物饮食(VLCD)干预对超重肥胖患者骨代谢指标的影响。方法将205例超重或肥胖受试者以1:3比例随机分配至 “单纯生活方式干预组”(对照组)和 “单纯生活方式加VLCD干预组”(干预组)。比较2种不同干预方式在干预前后体重、体重指数(BMI)、腰围及甲状旁腺素(PTH)、β胶原特殊序列(β-CTx)、总N端骨钙素(TNOC)、I型前胶原氨基端延长肽(P1NP)、25-羟化维生素D3[25-(OH)-D3]的变化。结果2种不同干预方式在干预后体重、BMI、腰围均较干预前明显下降，但VLCD治疗组在干预后下降较对照组明显(P<0.01)。2组干预前后骨代谢指标变化差异无统计学意义(P>0.05)。结论短期VLCD护理对超重肥胖患者体重、BMI、腰围明显改善，对骨代谢指标总体无明显影响。

VLCD干预；超重；肥胖；骨代谢

Abstract：[Objective] To investigate the effects of a short-term very low carbohydrate diet (VLCD) intervention on bone turnover of overweight and obese subjects. [Method] A total of 205 overweight or obese subjects were recruited and randomized into control group and treatmeat groupwith a ratio of 1:3. The control group received medical lifestyle intervention, while the intervention group received very low carbohydrate diet intervention in addition to medical lifestyle intervention.Body weight, waist circumstance, BMI, Parathyroid hormone(PTH), β-crosslaps(β-CTx), N-terminal osteocalcin (TNOC) , total procollagen I type N-terminal propeptide (P1NP) and 25-OH-D3of each subjectwere measuredbefore and after the intervention. [Result] The body weight, BMI and waist circumstancewere significantly decreased in the both groups, butshowed more significantdecreasein the VLCD intervention group (P< 0.01).There were no significant difference in bone turnover between the two groups after intervention (P>0.05). [Conclusion]Short-term very low carbohydrate diet intervention can improve body weight, BMI and waist circumstance in overweight or obese subjects while has no significant impact on bone turnover.

Keywords: very low carbohydrate diet; overweight; obese; bone turnover

超重和肥胖症会引发一系列健康、社会和心理问题。已有证据表明超重和肥胖症是心血管病、糖尿病、某些癌症和其他一些慢性疾病的重要危险因素[1]。传统流行病学调查显示，超重和肥胖可以通过增加骨负重，促进骨形成[2]。然而也有研究显示，在中国人和高加索人种中，在校正了机械应力作用后，增加的脂肪含量与骨质量呈负相关[3]。本研究拟通过极低碳水化合物饮食(Very Low Carbohydrate Diet，VLCD)护理干预探讨是否对超重肥胖患者骨代谢指标产生影响。