4周有氧运动对肥胖儿童青少年身体形态、血脂和血胰岛素的影响

目的:观察4周有氧运动对肥胖儿童青少年身体形态、血脂和血胰岛素的影响,探讨运动减肥对肥胖儿童青少年健康的促进作用。方法:以2007～2009年参加上海巅峰运动减肥夏令营的126名(男64名,女62名)8~17岁,体脂率>30%的肥胖儿童青少年为研究对象,入营时测试身高、体重、体脂率、BMI、脂肪体重、腰围、臀围、大腿围、空腹血胰岛素(FIN)、空腹血脂(TC、TG、HDL-C、LDL-C)、空腹血糖(FBG),经运动负荷试验和体格检查,排除心血管机能障碍等危险因素后确定个体运动减肥方案。以心率为运动强度监控指标,目标心率=安静心率+心率储备×(20%～40%)。选择强度容易控制、能持续长时间的运动方式,如游泳、快走、慢跑、健美操、羽毛球、篮球等。运动过程中遥测心率实时监控运动强度。根据研究对象的年龄、体重和基础代谢率计算其每天热能生理需要量,由专业营养师配餐。4周后测定相同指标并与入营时比较。结果:4周后,肥胖儿童青少年体重、体脂率、BMI、脂肪体重、腰围、臀围、大腿围、腰围身高比、臀围身高比和大腿围身高比与入营时比较均显著下降(P<0.01),体脂率下降明显大于体重和BMI。入营时,肥胖儿童青少年普遍存在血脂异常,空腹血胰岛素明显升高。4周运动减肥后,肥胖儿童青少年空腹血胰岛素、血脂和血糖水平与入营时相比均有明显改善。结论:肥胖儿童青少年已经存在脂类代谢紊乱倾向和胰岛素抵抗倾向。4周有氧运动结合适量饮食控制可以有效改善肥胖儿童青少年的身体形态,改善脂代谢紊乱和胰岛素抵抗,预防代谢综合征。与体重、BMI相比,体脂率是评价肥胖程度和减肥效果的首选指标。     

有氧运动干预对2型糖尿病患者血清网膜素-1及糖、脂代谢的影响

目的:探讨有氧运动对2型糖尿病(Type 2 Diabetes Mellitus,T2DM)患者血浆网膜素-1(Omentin-1)水平及糖、脂代谢相关指标的影响。方法:选取T2DM患者62例,随机分为T2DM对照组和T2DM运动干预组各31例,另选取正常健康对照组51例。运动干预组进行为期12周的有氧运动干预,T2DM对照组及正常健康对照组维持原有生活方式不变。于运动干预前后分别测量患者体质量、身高、腰围、臀围,计算体质指数(BMI)、腰臀比(WHR),检测空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血浆胰岛素(Fins)、Omentin-1、脂联素、口服75g葡萄糖后2小时血糖(2h PG),计算稳态模型胰岛素抵抗指数(HOMA-IR)、内脏脂肪面积。分析以上指标变化情况及其与Omentin-1的相关性。结果:运动干预前,糖尿病运动干预组和糖尿病对照组除HDL-C、Omentin-1及脂联素外,其余各临床和代谢指标均高于正常对照组,HDL-C、Omentin-1及脂联素低于正常对照组,差异均有统计学意义(P<0.05)。T2DM患者中,基线水平血浆Omentin-1与FBG、HOMA-IR、TC及腰围呈负相关(P<0.05),与脂联素、HDL-C呈正相关(P<0.05)。多元逐步回归分析显示脂联素、腰围、FBG是空腹血浆Omentin-1的独立相关因素。与运动干预前相比,运动干预后T2DM患者的BMI、腰围、WHR、内脏脂肪面积、TC、LDL-C、FBG,Fins、HBA1c、HOMA-IR、Omentin-1等指标均发生显著变化,其差异具统计学意义(P<0.05)。结论:12周有氧运动干预增加了T2DM患者血浆Omentin-1水平;患者全身代谢指标也发生显著改善。     

4周有氧运动对不同肥胖程度、肥胖类型儿童少年血清胰岛素水平的影响

目的:探讨4周有氧运动对不同肥胖程度、肥胖类型儿童少年血清胰岛素水平的影响。方法:以参加2011年上海巅峰运动减肥夏令营的82名肥胖儿童少年为研究对象,进行4周有氧运动为主结合适当饮食控制的减肥运动训练,实验前后测定身高、体重、体脂率、腰围等身体形态指标及空腹血清胰岛素水平。分别依据体脂率、腰围身高比,对受试对象进行肥胖程度及肥胖类型分组。结果:实验前,肥胖儿童少年血清胰岛素水平由高到低依次为:极重度肥胖组>重度肥胖组>中度肥胖组>轻度肥胖组>超重组,腹型肥胖组胰岛素水平显著高于周围型肥胖组(P<0.01)。实验后,受试对象腰围身高比、体脂率、胰岛素均显著下降(P<0.01),胰岛素下降幅度由高到底依次为:极重度肥胖组>重度肥胖组>中度肥胖组>轻度肥胖组>超重组。腹型肥胖组各指标下降幅度均大于周围型肥胖组(P<0.01)。结论:儿童少年血清胰岛素水平随肥胖程度加重而升高,腹型肥胖者胰岛素水平较周围型显著升高,有氧运动减肥是降低肥胖儿童少年尤其腹型肥胖者肥胖程度和血清胰岛素水平的有效途径。     

24周运动后肥胖绝经妇女血清脂联素水平及胰岛素抵抗的变化

目的:探讨24周不同方式的规律运动对肥胖绝经妇女血清脂联素水平和胰岛素抵抗的影响。方法:将36名受试者随机分成有氧练习组(AE)、有氧练习结合抗阻力练习组(AE RE)及对照组(CON),进行24周的实验,实验前后测量身体形态指标、空腹血糖(FPG)、血脂、胰岛素(FINS)及血清脂联素(ADI),并计算胰岛素抵抗指数(HOMA-IR)。结果:两运动组的体脂含量(FM)、体脂百分比(%F)、体重、腰臀比(WHR)、FPG、FINS和HOMA-IR水平均较实验前显著下降;血清ADI水平呈上升趋势(AE组上升7.7%,AE RE组上升17.2%),但无统计学意义。实验后两运动组各指标间无显著性差异。按照实验后体重变化分组,体重下降大于3kg的组脂联素变化水平显著高于未下降组。结论:24周不同方式运动显著改善胰岛素抵抗状态,但对脂联素水平无显著影响;脂联素水平上升不是运动导致的胰岛素抵抗改善的必要条件。     

4周运动结合饮食控制对肥胖青少年体脂分布与血脂代谢的影响

目的:观察4周运动结合饮食控制减肥后青少年体脂分布与血脂代谢的变化,探索体脂分布与血脂代谢间的关系。方法:招募12名肥胖青少年(6男6女)进行每周6天、共4周的运动训练,并按极轻体力劳动的能量需求,控制每人每天摄入的热量。在实验前后,用双能X线吸收测定法(DEXA)测试受试者的体脂率(Fat%)、脂肪质量(FM)以及上肢FM、下肢FM、躯干FM;受试者晨起空腹取静脉血,测试甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);测量受试者的身高、体重,计算身体质量指数(BMI)。比较身体不同部位脂肪质量下降率(ΔFM%),并以ΔBMI、ΔFat%、ΔFM、Δ上肢FM、Δ下肢FM、Δ躯干FM为自变量,以ΔTC、ΔTG、ΔHDL-C、ΔLDL-C为因变量进行相关分析。结果:4周减肥后,受试者体重、BMI、FM、Fat%均显著下降;下肢FM、上肢FM、躯干FM均显著下降,其中下肢ΔFM%显著小于上肢与躯干ΔFM%;男生TC、LDL-C显著下降,女生HDL-C显著升高、LDL-C显著下降;相关性分析发现女生躯干ΔFM与ΔLDL-C高度相关(r=0.830)。结论:4周运动结合饮食控制使青少年体重、体脂显著下降,血脂代谢有一定改善。在减肥过程中,不同部位脂肪的下降是不均衡的,身体下肢的脂肪比上肢与躯干的脂肪更难以减少。青少年女性躯干脂肪的减少与血脂代谢的改善密切相关。     

不同配方高脂饲料构建SD大鼠肥胖模型的实验研究

目的:研究不同配方高脂饲料对构建SD大鼠肥胖模型成功率的影响。方法:40只5周龄雄性SD大鼠随机分成4组:C组(SPF级繁殖鼠料),H1组(40%自配高脂饲料)、H2组(45%高脂饲料)、H3组(60%高脂饲料),每组10只。每周称量大鼠体重,饲养11周后大鼠麻醉处死,测量每只大鼠的体长、脂肪重量(肾周脂肪和附睾脂肪),计算其脂体比、BMI和Lee’s指数;检测大鼠的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)浓度。分析各组间上述指标的差异性,综合评估不同配方饲料对SD大鼠肥胖的影响。结果:(1)H2组大鼠自第8周体重显著高于对照组(P<0.05),且建模效率最高;(2)45%高脂饲料显著升高大鼠血清TC、TG和LDL-C浓度,而显著降低HDL-C浓度(P<0.05);(3)60%高脂饲料极显著升高大鼠血清TC和TG浓度(P<0.01),显著升高LDL-C浓度(P<0.05),而极显著降低HDL浓度(P<0.01);H2和H3组大鼠肾周脂肪重量、附睾脂肪重量、脂体比和Lee’s指数显著高于对照组。结论:(1)构建SD大鼠肥胖模型成功的判断标准:高脂饲料组体重显著增加,TC、TG、LDL-C显著升高,HDL-C显著降低,脂体比显著增加,Lee’s指数显著升高;且个体体重超过对照组平均体重20%。(2)喂饲6周是利用45%脂供能高脂饲料构建SD大鼠肥胖模型最经济的建模周期。     

4周运动减肥对肥胖青少年血浆致动脉粥样硬化指数和脂酰辅酶A胆固醇酰基转移酶2的影响

目的:观察运动减肥对肥胖青少年血浆致动脉粥样硬化指数和脂酰辅酶A胆固醇酰基转移酶等动脉粥样硬化致病相关因子的影响。方法:以参加2011年上海巅峰运动减肥夏令营的30名肥胖青少年为对象,进行4周中小强度有氧运动为主结合适当饮食控制的减肥运动训练。分别于入营第一天和出营前一天进行身体形态及血液指标测试。结果:经过夏令营4周有氧运动训练,肥胖青少年体重、体脂率、BMI与运动前相比显著下降,空腹血清胰岛素、血脂水平与运动前相比均明显改善,血浆致动脉粥样硬化指数、脂酰辅酶A胆固醇酰基转移酶2水平显著降低。结论:4周有氧运动明显降低了肥胖青少年的肥胖程度和胰岛素水平,改善血脂代谢,在一定程度上降低了动脉粥样硬化发病的风险。     

间歇性低氧和运动对高脂饮食诱导胰岛素抵抗大鼠血清内脂素的影响

目的:探讨间歇性低氧和运动对高脂饮食诱导的胰岛素抵抗大鼠血清内脂素的影响。方法:将72只雄性SD大鼠随机分为普通对照组(12只)和高脂造模组(60只),高脂造模组给予高脂饲料。6周末随机取12只高脂造模组大鼠处死,普通对照组同期处死,测试其空腹血糖和胰岛素水平,根据胰岛素抵抗指数(HOMA-IR)确定造模成功后,将其余48只高脂造模组大鼠分为常氧安静组、低氧安静组、常氧运动组和低氧运动组,每组各12只。低氧组暴露在14.5%氧浓度的环境中,4h/d,7d/w;运动组常氧状态下以20m/min进行跑台运动,1h/d,5d/w。4周末,测试各组大鼠血糖、血胰岛素、血清内脂素和内脏脂肪总量等指标。结果:6周高脂饮食后,高脂组大鼠胰岛素抵抗指数显著升高,造模成功。与常氧安静组比较,低氧安静组、常氧运动组胰岛素抵抗指数和血清内脂素均显著下降(P<0.01);低氧运动组血清内脂素较常氧运动组显著升高(P<0.01),与常氧安静组比较无显著性差异(P>0.05)。结论:间歇低氧和有氧运动均可有效改善胰岛素抵抗,并降低血清内脂素水平;而间歇低氧和运动双重作用对血清内脂素的影响不显著。     

间歇低氧暴露对高脂膳食大鼠胰岛素敏感性的影响

目的:探讨间歇低氧暴露对高脂膳食肥胖大鼠胰岛素抵抗的影响。方法:40只雄性SD大鼠随机分为普通膳食常氧组、普通膳食间歇低氧组、高脂膳食常氧组、高脂膳食间歇低氧组。普通膳食采用普通饲料,高脂膳食采用高脂饲料,间歇低氧暴露采用常压低氧方法,氧浓度控制在15.4%,每天10小时。干预6周后取材测试大鼠内脏脂肪总量、空腹血糖和胰岛素,并计算胰岛素敏感指数。结果:与普通膳食常氧组相比,高脂膳食常氧组大鼠Lee指数、内脏脂肪总量和血清胰岛素水平极显著增加而胰岛素敏感指数极显著下降(P<0.01),但普通膳食间歇低氧组大鼠Lee指数、内脏脂肪总量显著减少(P<0.05,P<0.01),胰岛素敏感指数显著升高(P<0.05);与高脂膳食常氧组比较,高脂膳食间歇低氧组大鼠Lee指数、内脏脂肪总量和胰岛素水平极显著下降(P<0.01),胰岛素敏感指数极显著提高(P<0.01)。相关性分析显示,内脏脂肪总量与胰岛素水平存在一定正相关,且胰岛素水平和胰岛素敏感指数存在高度负相关(P<0.01)。结论:体内脂肪总量增加可使血清胰岛素水平升高,胰岛素敏感性下降,而间歇低氧暴露可以减少高脂膳食大鼠体内脂肪含量,提高胰岛素敏感性,改善胰岛素抵抗。     

运动对肥胖大鼠血清脂联素、血脂及体脂水平的影响

目的:探讨运动对肥胖大鼠血清脂联素和血脂水平的影响,从血清脂联素的角度探讨运动干预肥胖的机制。方法:断乳5天SD健康雄性幼鼠40只,体重75～85g,随机分为普通饲料喂养组和高脂饲料喂养组。3周后从高脂饲料喂养组筛选出肥胖鼠,并随机分为不运动对照组和运动干预组。运动大鼠进行游泳运动,运动时间第1周为30min/d、第2周为60min/d(运动30min,休息5min)、第3周为90min/d(运动30min,休息5min)、第4周为120min/d(运动30min,休息5min),每周运动6天,周日休息,共4周。实验后安静时处死所有大鼠,测试血清脂联素、血脂水平及体脂。实验期每周测量体重及Lee’s指数。结果:高脂饲料喂养3周后大鼠体重和Lee’s指数较实验前分别增加了176.45%(P<0.05)和11.53%(P<0.05),而肥胖大鼠运动4周后体重和Lee’s指数较不运动对照组显著降低(P<0.05)。而睾丸脂肪垫和腹膜后脂肪质量仍明显增加(P<0.05),但与肥胖不运动大鼠比较减少(P>0.05)。肥胖大鼠血清脂联素水平下降,血脂水平增高,而运动4周后,血清脂联素增加了51.81%(P<0.05),总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)明显下降(P<0.05),而HDL-C的变化无统计学意义。结论:游泳训练使肥胖大鼠体重、体脂、Lee’s指数和血脂水平显著下降,血清脂联素水平显著提高。     

不同标准判定的肥胖患者脂肪细胞因子血清水平的临床意义比较

目的探讨3种代谢综合征(MS)诊断标准判定的肥胖患者脂联素(Adiponectin,APN)、抵抗素(Resistin,RST)、瘦素(Leptin,LPT)血浆水平临床意义的异同。方法采用2004中华医学会糖尿病学会(CDS)、2005国际糖尿病联盟(IDF)和2007中国成人血脂异常防治指南(CALIP)MS诊断标准中对肥胖的判定切点,将80名研究对象分为肥胖组和非肥胖组。测量体脂参数、血压,检测临床生化指标,测定空腹血浆胰岛素(FINS)、APN、RST、LPT、高敏C反应蛋白(hsCRP)、肿瘤坏死因子(TNF)α、白介素(IL)6、尿微量白蛋白(UAE)等。计算胰岛素抵抗指数(HOMA-IR)、分泌指数(HOMA-β)、敏感指数(ISI)。结果(1)3种不同标准的肥胖组血浆APN水平均显著低于非肥胖组(P均<0.01)。(2)血浆RST水平在2004CDS肥胖组显著高于非肥胖组(P<0.01),在2005IDF和2007CALIP肥胖组与非肥胖组间差异无统计学意义。(3)血浆LPT水平在2005IDF和2007CALIP肥胖组显著高于非肥胖组(P<0.01,P<0.05),在2004CDS肥胖组与非肥胖组间差异无统计学意义。(4)总体分析,血浆APN与性别呈显著正相关,与体重指数(BMI)、腰围(WC)、收缩压(SBP)、ln FINS、lnHOMA-IR、总胆固醇(TC)、ln三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、lnhsCRP呈显著负相关;血浆RST与lnhsCRP呈显著正相关,与腰臀比(WHR)呈显著负相关;血浆LPT与性别、年龄、BMI、ln空腹血浆血糖(FPG)、lnFINS、lnHOMA-IR、TC、高密度脂蛋白胆固醇(HDL-C)、LDL-C呈显著正相关,与WHR、ISI呈显著负相关;多元逐步回归分析,WC、lnhsCRP与血浆APN独立相关,WHR、lnhsCRP与血浆RST独立相关,性别、BMI、ISI、LDL-C与血浆LPT独立相关。(5)血浆APN在不同标准的各肥胖组均与性别呈显著正相关,在2005IDF和2007CALIP时与WC、lnTG呈显著负相关;在各非肥胖组均与WC呈显著负相关,在2004CDS和2007CALIP时还与BMI、TC呈显著负相关。血浆RST在各肥胖组均与lnhsCRP呈显著正相关,在非肥胖组2004CDS和2007CALIP时与lnFPG显著正相关。血浆LPT在各肥胖组与性别均呈显著正相关;各非肥胖组均与性别、lnFPG、lnHOMA-IR呈显著正相关,2004CDS和2007CALIP时还与BMI、lnFINS呈显著正相关,2005IDF和2007CALIP时还与TC呈显著正相关,均与WHR呈显著负相关。多元逐步回归分析,在不同标准各肥胖组性别、BMI均与血浆APN独立相关,lnhsCRP与血浆RST独立相关;在各非肥胖组WC均与血浆APN独立相关;性别在各标准的肥胖组和非肥胖组均与血浆LPT独立相关。结论3种不同标准的肥胖组血浆APN水平均显著低于非肥胖组,而血浆RST和LPT水平在不同标准下不一致;血浆APN在各肥胖组均与性别呈显著正相关,在各非肥胖组均与WC呈显著负相关;血浆RST在各肥胖组均与lnhsCRP呈显著正相关;血浆LPT在各肥胖组与性别均呈显著正相关,各非肥胖组均与性别、lnFPG、lnHOMA-IR呈显著正相关;在各肥胖组性别、BMI与血浆APN独立相关,lnhsCRP与血浆RST独立相关;WC在各非肥胖组均血浆APN独立相关;性别在各分组均与血浆LPT独立相关。     

Obesity classification in military personnel: a comparison of body fat, waist circumference, and body mass index measurements

OBJECTIVE: The purpose of this study was to evaluate obesity classifications from body fat percentage (BF%), body mass index (BMI), and waist circumference (WC). METHODS: A total of 451 overweight/obese active duty military personnel completed all three assessments. RESULTS: Most were obese (men, 81%; women, 98%) using National Institutes of Health (NIH) BF% standards (men, >25%; women, >30%). Using the higher World Health Organization (WHO) BF >35% standard, 86% of women were obese. BMI (55.5% and 51.4%) and WC (21.4% and 31.9%) obesity rates were substantially lower for men and women, respectively (p < 0.05). BMI/WC were accurate discriminators for BF% obesity (theta for all comparisons >0.75, p < 0.001). Optimal cutoff points were lower than NIH/WHO standards; WC = 100 cm and BMI = 29 maximized sensitivity and specificity for men, and WC = 79 cm and BMI = 25.5 (NIH) or WC = 83 cm and BMI = 26 (WHO) maximized sensitivity and specificity for women. CONCLUSIONS: Both WC and BMI measures had high rates of false negatives compared to BF%. However, at a population level, WC/BMI are useful obesity measures, demonstrating fair-to-high discriminatory power.     

Effects of a resistive training program on lipoprotein--lipid levels in obese women.

The purpose of this study was to determine the effects of a resistive training program on the time course of changes in strength, body mass index, lipids, lipoproteins, and apolipoproteins in sedentary obese women. Sixteen sedentary obese women strength trained 3 times . wk-1 for 12 wk performing three sets of six to eight repetitions per set with sets 1 and 2 at 60-70% of one-repetition maximum. During set 3, the subjects used the greatest weight possible so that failure occurred between six to eight repetitions. Six sedentary obese women served as controls. Blood samples for serum total cholesterol (TC), high-density lipoproteins (HDL-C), low-density lipoproteins (LDL-C), triglycerides (TG), TC/HDL-C ratio, apolipoprotein A-I (apo A-I), and apolipoprotein B-100 (apo B-100) were obtained pre, and after 4, 8, and 12 wk of training and approximately 3-4 d following the last training session. A 3-d dietary record was obtained on all subjects pre and post, and subjects were instructed not to alter their diet. The 12 wk of resistive training did not result in a significant change in body weight, BMI, or total kilocalories consumed per day but did show a mean improvement of 58% in muscular strength (P less than 0.05). The training program did not significantly alter the TC, HDL-C, LDL-C, TG, TC/HDL-C ratio, apo A-I, or apo B-100 levels, which suggests that this increase in strength owing to resistive training in the absence of body weight loss did not alter the lipid profiles in these sedentary obese women.     

Blood lipids in young distance runners

PURPOSE: The purpose of this study was to examine the age-and sex-associated variation in blood lipids among young athletes. METHODS: A mixed-longitudinal design was used to examine the development of blood lipids in competitive young distance runners followed from 1982 to 1985. Serial data included 99 annual measurements for 27 male subjects and 84 annual measurements for 27 female subjects aged 9-18 yr. Total cholesterol (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), and triglycerides (TG) were determined by standard procedures. RESULTS: In general, cross-sectional age group means showed that TC and LDL-C remained stable and HDL-C declined with age, especially in male subjects. TG increased with age. Age-related trends were statistically significant for HDL-C and TG in boys only (P < 0.05). TC and LDL-C were slightly greater in boys at all ages except 11, 15, and 17 yr (P > 0.05). HDL-C was similar between the sexes until 13 yr when values became greater in girls (3.2-13.8 mg.dL(-1)) (P < 0.05 in 17+ yr). No clear pattern of sex differences emerged for TG. Compared with the general population, blood lipids of young distance runners showed the following trends: 1) TC was above reference medians, 2) LDL-C tended to approximate or to be slightly above reference medians, 3) TG fluctuated about the reference medians, and 4) HDL-C was higher in distance runners compared to the reference medians before age 14 yr, but in the older age groups, especially male subjects, HDL-C either approximated or fell slightly below the reference medians. There was considerable variability in blood lipid levels among the runners. In 21 male and 18 female subjects with serial data for 3-5 yr, HDL-C declined 22.4 and 18.3 mg.dL(-1) (P < 0.05), whereas TG increased 18.0 and 14.0 mg.dL(-1)(P < 0.05 in female subjects only) in male and female subjects, respectively. Tracking coefficients over intervals of 3-5 yr were moderate to high (0.48-0.90), except for TG in male subjects (0.08). CONCLUSIONS: The results indicate that the development of blood lipids in young distance runners is similar to youth in the general population. In contrast to observations in adult endurance athletes, young distance runners did not possess a superior blood lipid profile except for HDL-C in the younger age groups.     

2型糖尿病与非糖尿病患者非酒精性脂肪肝发病情况的临床分析

目的研究2型糖尿病(T2MD)患者与非糖尿病患者非酒精性脂肪肝发病情况和特点。方法选择T2MD非酒精性脂肪肝患者50例(A组),非糖尿病非酒精性脂肪肝患者50例(B组)和健康人群50例(C组),观察分析三组人员的相关临床检测指标。结果非酒精性脂肪肝患者的体质量指数(BMI)、空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均高于健康组(P<0.05);A组患者的FBG、TC、TG、LDL-C指标方面均显著高于B组,HDL-C、胰岛素敏感指数(HOMA-ISI)指标均明显低于B组(P<0.05)。结论糖尿病会加剧非酒精性脂肪肝病情,为了能有效预防和控制非酒精性脂肪肝,应改变饮食结构、控制体质量,加强锻炼,并做到定期体检,做到及早发现,及时诊断治疗。     

国产辛伐他汀治疗原发性高胆固醇血症的临床观察

为探讨国产辛伐他汀对原发性高胆固醇血症的调脂作用,本文观察了４２例高胆固醇血症患者,根据血清ＴＣ水平随机按１：１分验证组及对照组各１３例,另设１６例开放验证,验证组服用国产辛了汀;对照组均服用进口舒降之,疗程均为８周。验证组与对照组均服药８周,降血清总胆固醇分别为２４．６％和２４．１％;降低密度脂蛋白胆固醇分别为３４．７％和３４．９％;     

Prevalence and determinants of hyperlipidemia in moderate altitude areas of the Yunnan-Kweichow plateau in Southwestern China

The objective of the current study was to determine the prevalence and determinants of hyperlipidemia among the populations living at moderate altitude on the Yunnan-Kweichow Plateau in Southwestern China. We randomly recruited 1415 people for this study. These subjects underwent a physical examination and a comprehensive questionnaire regarding their daily habits and diets. Furthermore, blood samples from the participants were collected for assessing the lipid profile. We found that 49.3% of participants (95% CI: 46.7-51.9%) suffered from hyperlipidemia. The prevalence in men was significantly higher than that in women (53.6% vs. 44.7%, p<0.01). The prevalence of hypercholesterolemia was 23.3% and of hypertriglyceridemia was 34.1%. Low HDL-C showed a prevalence of 17.5% and high LDL-C of 9.0%. The prevalence of hyperlipidemia also increased with age, as did the prevalence of high TC, TG, and LDL-C. Hyperlipidemic subjects tended to be older and have a higher BMI and WHR than the normolipidemic subjects in the study cohort (p<0.05). The hyperlipidemic subjects, both men and women, tended to dine out often and consume more animal-based foods and alcohol. In addition, the hyperlipidemic men in our cohort consumed more salted food then their normolipidemic counterparts (p<0.01). Normolipidemic subjects of both sexes were also found to prefer a vegetarian diet (p<0.01). Age, alcohol consumption, a preference for meat and animal products, regular dining out, and BMI were found to be the main determinants of hyperlipidemia in women, whereas a prevalence of salted food was observed to be related to hyperlipidemia in men from the Yunnan-Kweichow Plateau subpopulation under study (p<0.05). The average daily energy, and protein and fat intakes of the sampled subjects were also higher than the levels set by the Chinese Recommendation Nutrient Intakes (RNI), while hyperlipidemic subjects had an even higher average daily intake of total fat, cholesterol, and lower dietary fiber compared with the normolipidemic subjects in the study group (p<0.05). In conclusion, this study reveals a higher prevalence of hyperlipidemia, hypercholesterolemia, hypertriglyceridemia, increased BMI and WHR values in men, as well as a slightly higher prevalence of low HDL-C and high LDL-C in women from Yunnan-Kweichow Plateau. The incidence of hyperlipidemia also increased with age, as did the prevalence of an abnormal TC, TG, LDL-C, and WHR in our study cohort. A high BMI, and less healthy living habits and dietary preferences thus play significant roles in the onset of hyperlipidemia.     

军事飞行人员非酒精性脂肪肝影响因素的分析

目的 分析军事飞行人员非酒精性脂肪肝(NAFLD)流行状况和影响因素,为防治NAFLD提供依据.方法 调查飞行人员年龄、飞行年限、机种,测定体质指数(BMI),检测丙氨酸转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、空腹血糖(FBG)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),及进行肝脏超声检查,根据有无NAFLD(分为2组)、BMI数值(分为2组)及ALT数值(分为3组)进行分组,并采用方差分析和Logistic回归分析处理数据.结果 426例男性飞行人员中,超重、NAFLD、ALT升高检出率分别为34.98%、19.48%和16.67%.超重组与体重正常组比较,NAFLD患病率、ALT异常率有显著差异(χ~2=145.152、58.959,P<0.01).与ALT<40 U/L组比较,40 U/L≤ALT<80 U/L组和ALT≥80 U/L组的BMI、TG,差异均有统计学意义(F=13.476、13.176,P<0.01).NAFLD组与对照组比较,年龄、飞行时间、BMI、ALT、AST、GGT、FBG、UA、TG、TC、LDL-C显著增高(t=2.287～7.002,P<0.05或0.01),而HDL-C水平显著降低(t=2.932,P<0.01).高速机种与低速机种组比较,年龄、飞行时间、BMI、ALT、AST、GGT、FBG、UA、TC、TG、HDL-C、LDL-C及NAFLD发病率差异均无统计学意义.单因素Logistic回归分析显示显著影响NAFLD的变量为BMI、TG和飞行机种(Z=37.353、8.658、4.486,P<0.05或0.01).结论 飞行人员NAFLD患病率偏高,存在超重、血脂异常等危险因素,早期发现并治疗NAFLD是阻止其发展及预防心脑血管事件的重要措施之一.