目的：评估低碳水化合物饮食对非酒精性脂肪肝肥胖患者体重和代谢综合征的影响。方法在3个月内对16例成年非酒精性脂肪肝肥胖患者，予以低碳水化合物饮食指导进行减重干预（碳水化合物占总供能比20％～40％，蛋白质占30％～60％，脂肪占20％～30％）。在干预前后分别检测16例参与者体重、体成分、血压等，空腹抽血测定丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿素、肌酐、尿酸和血糖等。结果16例患者采用3个月内的低碳水化合物减重干预后体重、身体质量指数、体脂肪、体脂肪百分比、内脏脂肪面积、腰围、腰臀比等，与干预前比较差异均有统计学意义（P＜0．05）。但是，骨骼肌含量也呈现一定程度地下降。患者减重干预后舒张压、空腹葡萄糖、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、胆固醇、三酰甘油、低密度脂蛋白胆固醇及尿酸水平均有所改善（P＜0．05）；而收缩压、高密度脂蛋白胆固醇，尤其是尿素和肌酐的改善并不显著（P＞0．05），说明减重过程中采用的特殊饮食模式未对肾功能产生不良影响。结论低碳水化合物饮食可以在短期内减轻非酒精性脂肪肝肥胖患者的体重并改善代谢综合征相关指标。%Objective To evaluating the effects of low-carbohydrate diet on body weight as well as on metabolic markers . Methods In a three-month uncontrolled study , 16 obese subjects with NAFLD were placed on a low-carbohydrate diet (20%-40%from carbohydrate, 30%-60%from protein, 20%-30%from fat;low glycemic load).At baseline and 3 months, measures included anthropometrics, body composition, blood pressure.Markers of liver function alanine aminotransferase (ALT), aspartate aminotrans-ferase (AST), total lipid profile, urea nitrogen, creatinine, uric acid and glucose were measured in fasting blood .Results In 3 months, a significant reduction in weight , body mass index, body fat, percentage of body fat, visceral fat area, waist circumference and waist-hip ratio were observed (both P<0.05 compared with baseline values ).In obese subjects with NAFLD the diastolic pres-sure, ALT, AST, triglycerides, total cholesterol, LDL cholesterol, uric acid and glucose levels were decreased to a greater extent after 3-month low-carbohydrate diet(P<0.05), without statistical changes in systolic pressure and HDL cholesterol (P>0.05).Conclu-sion A low-carbohydrate diet result in weight loss and may improve markers of the metabolic syndrome in the short time .
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