肥胖婦女減重對其與常見代謝疾病相關之血中指標之影響

Numerous studies demonstrate a positive correlation between chronic diseases and obesity, and weight reduction prevents or ameliorates the presence or the severity of the diseases. This study focused on the effect of weight reduction on the changes of blood indices related to some metabolic diseases. The subjects of this study were 67 premenopause obese women, those with body mass index (BMI) between 26.4 to 30.8 kg/m² considered as mild obese, and those with BMI > 30.8 kg/m² as moderately obese. The obese subjects were controlled by a low kcal diet for half a year to lose weight. Twenty-nine women lose 5% of their initial body weight. Changes of blood parameters were measured before and after weight reduction, and 18 age matched normal weight women served as control. The results demonstrated that plasma albumin and hematocrit were not significantly different between obese and normal weight groups, hemoglobin was even higher in the obese group than that in normal weight group. No significant differences in plasma concentrations of albumin, hematocrit and hemoglobin were seen before and after weight reduction. This result indicates that low kcal diet intake does not influence the general nutritional status of the obese subjects during weight loss. More than half of the obese women (41/67) had higher plasma asparate aminotransferase (AST) and alanine aminotransferase (ALT) activities, whereas only 16.7% of the normal weight women (3/18) had abnormal AST, ALT activities. Weight reduction did not normalize the enzyme activities in this study. Plasma uric acid was significantly higher in moderately obese group than that of mildly obese and normal weight groups. No significant difference in fasting blood sugar among mildly, moderately obese and normal weight groups, however, insulin levels were significantly different among the 3 groups, increased in accordance with the degree of obesity (P <0.0001). Weight reduction significantly lowered the plasma glucose, insulin as well as uric acid concentrations (P <0.01), although plasma insulin and uric acid levels were still higher than those in normal weight group. Plasma glucose and insulin response to the glucose tolerance test showed weight reduction had no effect on the decrement of insulin levels. However, plasma glucose levels at 120 and 150 minute were significantly lower after weight reduction than those before weight loss. These results suggest that weight reduction more than 5% of initial body weight significantly lowers plasma concentrations of uric acid, insulin as well as glucose, and insulin resistance induced by obesity is also improved after weight reduction.