背景:肥胖和代谢综合征(MetS)已成为全球紧迫的健康问题,患者易患不良心肌状况和甲状腺功能异常。低碳水化合物饮食(LCD)和限时饮食(TRE)已被证实是体重管理和改善MetS的有效方法,但它们对心肌和甲状腺的影响尚不清楚。
方法:我们在一项随机临床饮食诱导体重减轻试验中进行了二次分析。被诊断为MetS的参与者(N=169)被随机分配到LCD组,8hTRE组,或LCD和TRE组组合3个月。在干预前后检测心肌酶和甲状腺功能。在基线时评估心肌和甲状腺功能与心脏代谢参数之间的Pearson或Spearman相关性。
结果:共有162名开始试验的参与者被纳入意向治疗(ITT)分析,符合方案(PP)分析涉及57名遵守指定方案的参与者.相对于基线,乳酸脱氢酶,肌酸激酶MB,羟丁酸脱氢酶,游离三碘甲状腺原氨酸(FT3)下降,和游离甲状腺素(FT4)在所有3项干预后增加(两项分析)。肌酸激酶(CK)仅在TRE中降低(-18[44]U/L,P<0.001)和组合(-22[64]U/L,P=0.003)组(PP分析)。促甲状腺激素(-0.24[0.83]μIU/mL,P=0.011)和T3(-0.10±0.04ng/mL,P=0.011)在联合组(ITT分析)中降低。T4(0.82±0.39μg/dL,P=0.046),甲状腺球蛋白抗体(TgAb,2[1]%,P=0.021),和甲状腺微粒体抗体(TMAb,2[2]%,P<0.001)增加,而T3/T4比值(-0.01±0.01,P=0.020)仅在TRE组中降低(PP分析)。然而,在任一分析中,组间均未观察到显著差异.在基线,CK与内脏脂肪面积呈正相关。FT3与甘油三酯和总胆固醇呈正相关。FT4与胰岛素和C肽水平呈负相关。TgAb和TMAb与腰臀比呈负相关。
结论:TRE伴或不伴LCD对MetS患者的心肌状态和甲状腺功能具有显著的代谢益处。
背景:ClinicalTrials.gov,NCT04475822。
BACKGROUND: Obesity and metabolic syndrome (MetS) have become urgent worldwide health problems, predisposing patients to unfavorable myocardial status and thyroid dysfunction. Low-carbohydrate diet (LCD) and time-restricted eating (TRE) have been confirmed to be effective methods for weight management and improving MetS, but their effects on the myocardium and thyroid are unclear.
METHODS: We conducted a secondary analysis in a randomized clinical diet-induced weight-loss trial. Participants (N = 169) diagnosed with MetS were randomized to the LCD group, the 8 h TRE group, or the combination of the LCD and TRE group for 3 months. Myocardial enzymes and thyroid function were tested before and after the intervention. Pearson\'s or Spearman\'s correlation was assessed between functions of the myocardium and thyroid and cardiometabolic parameters at baseline.
RESULTS: A total of 162 participants who began the trial were included in the intention-to-treat (ITT) analysis, and 57 participants who adhered to their assigned protocol were involved in the per-protocol (PP) analysis. Relative to baseline, lactate dehydrogenase, creatine kinase MB, hydroxybutyrate dehydrogenase, and free triiodothyronine (FT3) declined, and free thyroxine (FT4) increased after all 3 interventions (both analyses). Creatine kinase (CK) decreased only in the TRE (- 18 [44] U/L, P < 0.001) and combination (- 22 [64] U/L, P = 0.003) groups (PP analysis). Thyrotropin (- 0.24 [0.83] μIU/mL, P = 0.011) and T3 (- 0.10 ± 0.04 ng/mL, P = 0.011) decreased in the combination group (ITT analysis). T4 (0.82 ± 0.39 μg/dL, P = 0.046), thyroglobulin antibodies (TgAb, 2 [1] %, P = 0.021), and thyroid microsomal antibodies (TMAb, 2 [2] %, P < 0.001) increased, while the T3/T4 ratio (- 0.01 ± 0.01, P = 0.020) decreased only in the TRE group (PP analysis). However, no significant difference between groups was observed in either analysis. At baseline, CK was positively correlated with the visceral fat area. FT3 was positively associated with triglycerides and total cholesterol. FT4 was negatively related to insulin and C-peptide levels. TgAb and TMAb were negatively correlated with the waist-to-hip ratio.
CONCLUSIONS: TRE with or without LCD confers remarkable metabolic benefits on myocardial status and thyroid function in subjects with MetS.
BACKGROUND: ClinicalTrials.gov, NCT04475822.