限能量平衡膳食对超重或肥胖多囊卵巢综合征患者体成分和代谢影响研究

摘要

目的 回顾性分析限能量平衡膳食(CRD)对超重或肥胖多囊卵巢综合征(PCOS)患者体成分和代谢指标的影响.方法 回顾分析南京大学医学院附属鼓楼医院收治的59例体重指数(BMI)≥24的PCOS经CRD干预前后的数据,测定了体成分、血脂、75 g口服葡萄糖耐量实验和同步胰岛素释放试验,并计算稳态模型评估胰岛素抵抗指数(HOMA-IR).采用配对t检验和McNemar卡方检验比较分析.结果 经12周干预,患者体重下降(7.21±3.76)kg(9.05％),体脂肪(BF)、体脂百分比(BFP)和内脏脂肪面积(VFA)分别下降16.15％、8.00％和12.59％,腰围∽C)减少(7.00±4.12) cm(6.96％)、腰臀比(WHR)下降3.16％(P均＜0.001);总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、胰岛素0 min和120 min均显著下降(P均＜0.05).胰岛素抵抗(IR,定义为HOMA-IR≥2.69)检出率由干预前89.83％降至干预后54.55％,代谢综合征(MS)的检出率由干预前67.80％降至干预后42.37％.结论 超重或肥胖PCOS患者经CRD干预可以减轻体重、BF、VFA,并改善脂代谢紊乱、IR和MS.%Objective The study was to retrospective analysis of calorie-restricted diet (CRD) intervention on body composition and metabolic parameters in overweight and obese patients with polycystic ovary syndrome (PCOS).Methods The data of 59 overweight and obese adult females with PCOS according to the Rotterdam criteria were retrospectively analyzed,who received CRD therapy.At baseline and at 12 weeks,measure their body composition (InBody720),blood lipid,7Sg oral glucose tolerance test (OGTT) and synchronous insulin release test.Homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated.Comparative analysis was done using paired T test and McNemar Chi square test.Results After 12 weeks of intervention,patients' body weight decreased (7.21±3.76)kg (9.05％).Body fat(BF),body fat percentage (BFP) and visceral fat area (VFA) decreased by 16.15％,8％ and 12.59％,respectively.Waist circumference (WC) decreased (7.00±4.12)cm (6.96％),and waist to hip ratio (WHR) decreased by 3.16％,P＜0.001.Total cholesterol (TC),low density lipoprotein cholesterol-C (LDL-C),triglyceride (TG),and insulin 0min and 120min all decreased significantly,and P values were ＜0.05.Insulin resistance (IR,defined as HOMA-IR ≥2.69) was detected in 89.83％ before the intervention,and 54.55％ after the intervention.The detection rate of MS was 67.80％ before the intervention,and 42.37％ after the intervention.Conclusions CRD intervention can reduce body weight,BF and VFA,and improve lipid metabolism disorder,IR and MS in overweight and obese patients with PCOS.