肥胖儿童膳食结构及营养素摄入情况分析

目的 分析肥胖儿童与正常儿童饮食结构及营养素摄入的差异,为肥胖干预提供科学依据。方法 以2016年6月—2017年6月至西安交通大学第二附属医院儿科内分泌门诊就诊的70名7～14岁单纯性肥胖患儿及70名体重正常儿童分别作为肥胖组及对照组,测量所有儿童身高、体重、腰围、臀围、血压和体脂,并计算体重指数(BMI)及腰臀比。对所有儿童采用3日24小时回顾法调查儿童每日摄入的总热量、三大营养物质的量、微量营养素及三餐比例等情况,并采用上海惠诚有限公司的膳食营养分析软件对儿童膳食结构及营养素摄入情况分析。结果 肥胖组与对照组相比,总热量及蛋白质、脂肪及碳水化合物、脂肪及蛋白质供能比、硫胺素和维生素A、钠、锌、铁、钙的摄入量显著升高,差异均有统计学意义(P均<0.01);但碳水化合物的供能比显著降低,差异有统计学意义(P＜0.01)。结论 肥胖儿童存在三大营养素及矿物质摄入比例失衡,长期营养摄入过量可导致肥胖,调整肥胖患儿的膳食结构时,需注意矿物质及维生素摄入比例。     

Association of Yogurt Consumption with Nutrient Intakes,Nutrient Adequacy,and Diet Quality in American Children and Adults

The popularity of yogurt has increased among consumers due to its perceived health benefits. This study examined the cross-sectional association between yogurt consumption and nutrient intake/adequacy, dietary quality, and body weight in children and adults. National Health and Nutrition Examination Survey 2001–2016 data (n = 65,799) were used and yogurt consumers were defined as those having any amount of yogurt during in-person 24-h diet recall. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) scores after adjusting data for demographic and lifestyle factors. The data show that approximately 6.4% children and 5.5% adults consume yogurt, with a mean intake of yogurt of 150 ± 3 and 182 ± 3 g/d, respectively. Yogurt consumers had higher diet quality (10.3% and 15.2% higher HEI-2015 scores for children and adults, respectively); higher intakes of fiber, calcium, magnesium, potassium, and vitamin D; and higher percent of the population meeting recommended intakes for calcium, magnesium, and potassium than non-consumers. Consumption of yogurt was also associated with lower body weight, body mass index (BMI), and 23% showed a lower risk of being overweight/obese among adults only. In conclusion, yogurt consumption was associated with higher nutrient intake, nutrient adequacy, and diet quality in both children and adults.     

血清补体C5a及相关炎症因子在肥胖伴高血压儿童中的水平及临床意义

目的 分析肥胖患儿体内补体C5a及相关炎性因子对血压的影响及其在高血压中的作用,为临床干预提供科学依据。方法 以2016年7月－2017年8月就诊于西安交通大学第二附属医院小儿内分泌门诊的71例肥胖儿童为研究对象,测量儿童身高、体重、腰围、体重指数(BMI)及血压,根据血压测量结果,收缩压(SBP)和(或)舒张压(DBP)≥同年龄同性别P₉₅为高血压,进一步分为高血压组31例和非高血压组40例。用酶联免疫法检测血中胰岛素、白介素-6(IL-6)、C5a、超敏C反应蛋白(hsCRP)和肿瘤坏死因子-α(TNF-α),并计算胰岛素抵抗指数(HOMA-IR),并对检测结果进行分析。结果 高血压组儿童与非高血压组比较,HOMA-IR、甘油三酯(TG)、总胆固醇(TC)显著升高(P<0.05);此外,肥胖组高血压患儿血中TNF-α,IL-6以及补体C5a显著升高,与非高血压组比较差异均有统计学意义(P<0.05);SDS-DBP及SDS-SBP均与炎性因子TNF-α、hs-CRP、IL-6及补体C5a之间呈显著正相关(P<0.05);多元线性回归显示SDS-BMI、腰围、IL-6、C5a及hsCRP与SDS-SBP显著相关(P<0.05);IL-6、C5a及hsCRP均与SDS-DBP显著相关(P<0.05)。结论 炎性因子IL-6与hsCRP以及补体C5a与肥胖儿童高血压的发生密切相关,可能是引起血压升高的危险因素。     

Inhibitory effects of Doenjang,Korean traditional fermented soybean paste,on oxidative stress and inflammation in adipose tissue of mice fed a high-fat diet

BACKGROUND/OBJECTIVES

Doenjang, Korean traditional fermented soybean paste has been reported to have an anti-obesity effect. Because adipose tissue is considered a major source of inflammatory signals, we investigated the protective effects of Doenjang and steamed soybean on oxidative stress and inflammation in adipose tissue of diet-induced obese mice.

MATERIALS/METHODS

Male C57BL/6J mice were fed a low fat diet (LF), a high-fat diet (HF), or a high-fat containing Doenjang diet (DJ) or a high-fat containing steamed soybean diet (SS) for 11 weeks.

RESULTS

Mice fed a DJ diet showed significantly lower body and adipose tissue weights than those in the HF group. Although no significant differences in adipocyte size and number were observed among the HF diet-fed groups, consumption of Doenjang alleviated the incidence of crown-like structures in adipose tissue. Consistently, we observed significantly reduced mRNA levels of oxidative stress markers (heme oxygenase-1 and p40^phox), pro-inflammatory adipokines (tumor necrosis factor alpha and macrophage chemoattractant protein-1), macrophage markers (CD68 and CD11c), and a fibrosis marker (transforming growth factor beta 1) by Doenjang consumption. Gene expression of anti-inflammatory adipokine, adiponectin was significantly induced in the DJ group and the SS group compared to the HF group. The anti-oxidative stress and anti-inflammatory effects observed in mice fed an SS diet were not as effective as those in mice fed a DJ diet, suggesting that the bioactive compounds produced during fermentation and aging may be involved in the observed health-beneficial effects of Doenjang.

CONCLUSIONS

Doenjang alleviated oxidative stress and restored the dysregulated expression of adipokine genes caused by excess adiposity. Therefore, Doenjang may ameliorate systemic inflammation and oxidative stress in obesity via inhibition of inflammatory signals of adipose tissue.     

中链甘油三酯饮食对神经肽Y及瘦素的作用研究

目的观察中链甘油三酯(MCT)对血清和下丘脑瘦素、神经肽Y(NPY)浓度,下丘脑长型瘦素受体(Ob-Rb)、mRNA表达的影响。方法20只Wistar雄性大鼠,用含30%MCT或长链甘油三酯(LCT)的饲料喂养8周,用ELISA法测定血清和下丘脑瘦素的水平,用放射免疫法检测外周血和下丘脑NPY的浓度,用real-time RT-PCR技术测定下丘脑NPY、瘦素受体(Ob-Rb)基因表达水平的差异。结果MCT组大鼠体重增长量和体脂含量均小于LCT组(P<0.01),MCT组瘦素脑/血比明显高于LCT组,MCT组大鼠下丘脑ob-Rb mRNA表达水平明显高于LCT组(P<0.01),下丘脑及血清NPY浓度明显低于LCT组(P<0.01)。结论MCT通过促进Ob-Rb基因表达,抑制NPY合成和分泌。     

特定穴位针刺治疗对肥胖模型小鼠血清血管生成因子的影响

目的:探讨特定穴位针刺治疗对高脂饮食肥胖模型小鼠血清血管生成因子的影响。方法:小鼠随机分为空白对照组、针刺对照组、模型对照组和针刺治疗组,每组6只。小鼠15周高脂饮食制备肥胖模型后,采用特定穴位针刺法干预治疗10天,酶联免疫法检测小鼠血清胰岛素、血管内皮细胞生长因子、可溶性血管内皮细胞生长因子受体、瘦素、一氧化氮水平。结果:肥胖模型小鼠血清胰岛素、一氧化氮以及瘦素水平上升,而血清血管内皮细胞生长因子以及可溶性血管内皮细胞生长因子受体水平没有明显变化;特定穴位针刺治疗可以显著降低血清一氧化氮、瘦素水平,并可提高肥胖模型小鼠血清血管内皮细胞生长因子含量,但对血糖水平、可溶性血管内皮细胞生长因子受体水平没有影响。结论:特定穴位针刺疗法具有较好的减肥作用,其作用机制可能与调节血管再生有关。     

盐酸小檗碱联合西格列汀治疗肥胖2型糖尿病的疗效观察

目的探讨盐酸小檗碱联合西格列汀治疗肥胖2型糖尿病的临床疗效。方法选取2014年8月—2015年8月在武安市第一人民医院内分泌科接受治疗的肥胖2型糖尿病患者96例为研究对象,按治疗方案的差别分为对照组和治疗组,每组各48例。对照组口服磷酸西格列汀片,100 mg/次,1次/d。治疗组在对照组基础上口服盐酸小檗碱片,0.3 g/次,3次/d,餐前口服。两组患者均连续治疗12周。观察两组的临床疗效,比较两组患者的血糖指标和炎症指标。结果治疗后,对照组和治疗组的总有效率分别为83.33%、95.83%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者的空腹血糖(FPG)、餐后2 h血糖及糖化血红蛋白(Hb A1c)均明显降低,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、内皮素-1(ET-1)及血栓素2(TXB2)均显著下降,而前列腺素Fla(PGFla)、一氧化氮(NO)均显著上升,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论盐酸小檗碱联合西格列汀治疗肥胖2型糖尿病具有较好的临床疗效,能明显降低患者血糖,改善炎症指标,具有一定的临床推广应用价值。     

Anti-diabetic action of Punica granatum flower extract: activation of PPAR-gamma and identification of an active component

Peroxisome proliferator-activated receptor (PPAR)-gamma activators are widely used in the treatment of type 2 diabetes because they improve the sensitivity of insulin receptors. Punica granatum flower (PGF) has been used as an anti-diabetic medicine in Unani medicinal literature. The mechanism of actions is, however, unknown. In the current study, we demonstrated that 6-week oral administration of methanol extract from PGF (500 mg/kg, daily) inhibited glucose loading-induced increase of plasma glucose levels in Zucker diabetic fatty rats (ZDF), a genetic animal model for type 2 diabetes, whereas it did not inhibit the increase in Zucker lean rats (ZL). The treatment did not lower the plasma glucose levels in fasted ZDF and ZL rats. Furthermore, RT-PCR results demonstrated that the PGF extract treatment in ZDF rats enhanced cardiac PPAR-gamma mRNA expression and restored the down-regulated cardiac glucose transporter (GLUT)-4 (the insulin-dependent isoform of GLUTs) mRNA. These results suggest that the anti-diabetic activity of PGF extract may result from improved sensitivity of the insulin receptor. From the in vitro studies, we demonstrated that the PGF extract enhanced PPAR-gamma mRNA and protein expression and increased PPAR-gamma-dependent mRNA expression and activity of lipoprotein lipase in human THP-1-differentiated macrophage cells. Phytochemical investigation demonstrated that gallic acid in PGF extract is mostly responsible for this activity. Thus, our findings indicate that PPAR-gamma is a molecular target for PGF extract and its prominent component gallic acid, and provide a better understanding of the potential mechanism of the anti-diabetic action of PGF.     

Age of onset of obesity and risk of type 2 diabetes

Objective : To compare a simple measure ‐ age of onset of obesity ‐ to an obese‐years construct (a product of duration and magnitude of obesity) as risk factors for type 2 diabetes. Method : Participants from the Framingham Heart Study who were not obese and did not have diabetes at baseline were included (n=4,320). The Akaike Information Criterion (AIC) was computed to compare four Cox proportional hazards models with incident diabetes as the outcome and: (i) obese‐years; (ii) age of onset of obesity; (iii) body mass index (BMI); and (iv) age of onset of obesity plus magnitude of BMI combined, as exposures. Results : AIC indicated that the model with obese‐years provided a more effective explanation of incidence of type 2 diabetes compared to the remaining three models. Models including age of onset of obesity plus BMI were not appreciably different from the model with BMI alone, except in those aged ≥60. Conclusions : While obese‐years was the optimal obesity construct to explain risk of type 2 diabetes, age of onset may be a useful, practical addition to current BMI in the elderly. Implications : Where computation of obese‐years is not possible or impractical, age of onset of obesity combined with BMI may provide a useful alternative.