高蛋白质营养代餐控制超重或肥胖合并高脂血症成年人体重效果随机对照双盲研究

发布时间：2018-04-14 23:14

本文选题：超重或肥胖 + 高脂血症　；参考：《中国实用内科杂志》2017年05期

【摘要】：目的探讨高蛋白质营养代餐对于超重或肥胖合并高脂血症人群的有效性和安全性。方法招募100例年龄≥30岁,体重指数(BMI)25~40的超重或肥胖合并高三酰甘油血症者,排除糖尿病、肾脏病、肝功能异常者。按照数字随机对照表分为2组:(1)试验组给予限能量高蛋白膳食(蛋白质供能30%,脂肪供能20%,碳水化合物供能50%)及代餐品(每份含24.1 g蛋白质,3.5 g脂肪,25.0 g碳水化合物);(2)对照组,给予限能量高碳水化合物膳食(蛋白质供能15%,脂肪供能20%,碳水化合物供能65%)及代餐品(每份含4.0 g蛋白质,2.4 g脂肪,49.0 g碳水化合物)。每天早餐和下午加餐食用代餐品各1份。观察12周,在起始、第2、4、8、12周测握力、人体成分、实验室检查及满意度和饥饿感评估。对所有人推荐增加日常活动量,每天30 min有氧运动,但并不强制体育训练。结果共93例受试者完成试验,其中试验组49例、对照组44例。入组前两组受试者除血糖外,所有代谢性指标差异均无统计学意义。试验结束后两组均降低了体重,平均下降(6.5±3.4)kg,均改善了胰岛素、肝功能、尿酸水平等代谢性指标。由第三方揭盲,发现在体脂水平、握力、血尿酸、白蛋白指标中,试验组有更佳的改善趋势,但由于两组均采用限制总能量摄入,代谢性指标差异无统计学意义。试验前后饥饿感、满意感差异均无统计学意义。结论对超重或肥胖且合并高脂血症者采用严格限能量代餐,能够改善除体重外的体成分及尿酸等代谢性指标,是安全有效的减重方法。
[Abstract]:Objective to investigate the efficacy and safety of high protein nutritional substitute for overweight or obesity with hyperlipidemia.Methods 100 cases of overweight or obesity with hypertriglyceridemia aged more than 30 years and body mass index (BMI) were recruited to exclude diabetes, kidney disease and abnormal liver function.According to the digital random control table, the experimental group was divided into two groups: the experimental group was given a high-energy and high-protein diet (30 for protein, 20 for fat, 50 for carbohydrate) and a substitute for meal (containing 24.1 g of protein and 3.5 g of fat and 25.0 g of carbohydrate).Give limited energy and high carbohydrate diet (protein 15, fat 20, carbohydrate 65) and food substitute (4.0 g protein 2.4 g fat 49.0 g carbohydrate).Breakfast and afternoons to eat substitute food 1 each.Grip strength, body composition, laboratory tests, satisfaction and hunger assessment were measured at 12 weeks after 12 weeks of observation.It is recommended to increase daily activity for all, 30 min daily aerobic exercise, but not mandatory physical training.Results A total of 93 subjects completed the test, 49 cases in the test group and 44 cases in the control group.There was no significant difference in all metabolic indexes except blood glucose between the first two groups.At the end of the experiment, both groups lost their body weight and decreased by 6.5 卤3.4 kg on average. The metabolic indexes such as insulin, liver function and uric acid level were improved.It was found that the indexes of body fat, grip strength, serum uric acid and albumin in the test group were better than those in the control group, but there was no significant difference in metabolic indexes between the two groups due to the restriction of total energy intake.There was no significant difference in hunger and satisfaction before and after the experiment.Conclusion for overweight or obese patients with hyperlipidemia, strict energy restriction is a safe and effective method to reduce body weight, which can improve body composition, uric acid and other metabolic indexes besides body weight.
【作者单位】：中国医学科学院北京协和医院肠外营养科;
【分类号】：R459.3;R589.2

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