目的:脂肪组织是人体最大的内分泌器官,随着质量的变化,它分泌的分子的血清水平也会发生变化。内脏脂肪组织指数(VAI)是内脏脂肪组织功能障碍的简单替代标记。这项研究评估了神经性厌食症(AN)和极端肥胖(EO)患者脂肪量变化对脂肪细胞因子行为和VAI的影响。
方法:研究组由三个亚组组成:第1组,接受肥胖手术的EO患者,BMI≥50kg/m2(n=20)。第2组,新诊断的AN患者(n=12)。第3组对照BMI为20-25kg/m2(n=20)。对AN和EO组进行随访,直到干预前后体重变化至少10%。
结果:干预前,EO患者表现出最低的apelin水平,门汀,和脂联素,而AN患者表现出这些标志物的最高水平。EO患者的瘦素和IL-6升高,AN患者的瘦素和IL-6降低。治疗后,AN患者的所有脂肪因子和VAI均增加,和门汀,脂联素,EO患者的IL-6增加,而apelin,瘦素,VAI下降。每种脂肪细胞因子的变化与其他脂肪细胞因子呈正相关(p<0.050),与代谢和VAI变化呈负相关(p<0.050)。回归分析确定以下变量与脂肪组织质量的变化相关:Δapelin(OR:1.061;p=0.028)和Δ脂联素(OR:1.057;p=0.036)。
结论:在具有病理性脂肪细胞质量的个体中,响应体重变化的脂肪细胞因子水平变化并不像预期的那样.在体重干预治疗的早期没有看到这些变化的事实表明这些患者具有代偿性生理机制来保护他们。此外,使用VAI而不是BMI,其可靠性越来越受到质疑,因为它不能反映身体脂肪量,可以被认为是一种替代。然而,在体重变化的早期阶段以及代谢参数达到极值的AN和EO患者中,可能存在建模误差.因此,应该在对更大的患者组进行更长时间随访的研究中进行测试.
OBJECTIVE: Adipose tissue is the largest endocrine organ in the human body, and as its mass changes, the serum levels of the molecules it secretes also change. Visceral adipose tissue index (VAI) is a simple surrogate marker of visceral adipose tissue dysfunction. This
study evaluated the effects of changes in fat mass on adipocytokine behavior and VAI in patients with anorexia nervosa (AN) and extreme obesity (EO).
METHODS: The
study group consisted of three subgroups: Group 1, patients with EO who were candidates for obesity surgery with BMI≥50 kg/m2 (n=20). Group 2, newly diagnosed patients with AN (n=12). Group 3 controls with BMI 20-25 kg/m2 (n=20). The AN and EO groups were followed until at least a 10% weight change before and after the intervention.
RESULTS: Prior to the intervention, EO patients exhibited the lowest levels of
apelin, omentin, and adiponectin, while AN patients demonstrated the highest levels of these markers. Leptin and IL-6 were elevated in EO and reduced in AN patients. After treatment, all adipokines and VAI increased in AN patients, and omentin, adiponectin, and IL-6 increased in EO patients, while
apelin, leptin, and VAI decreased. The change in each adipocytokine (∆) was positively correlated with the other adipocytokines (p<0.050) and negatively correlated with metabolic and VAI changes (p<0.050). The regression analysis determined that the following variables were associated with the change in adipose tissue mass: Δapelin (OR: 1.061; p=0.028) and Δadiponectin (OR: 1.057; p=0.036).
CONCLUSIONS: In individuals with pathological adipocyte mass, the change in adipocytokine levels in response to weight change is not as expected. The fact that these changes are not seen in the early period of the weight intervention treatment indicates that these patients have compensatory physiological mechanisms to protect them. In addition, using VAI instead of BMI, whose reliability is increasingly questioned because it does not reflect body fat mass, can be considered an alternative. However, there may be modeling errors in the early stages of weight change and in AN and EO patients where metabolic parameters reach extreme values. Therefore, it should be tested in studies where larger patient groups are followed for a more extended period.