Effects of an 8-week weight control program on seruminflammatory markers and risk factors for metabolic syndrome in android-type obese subjects

Abstract

肥胖特別是腹部肥胖，其罹患代謝症候群風險高於一般人，而有代謝症候群者，罹患心血管疾病的危險遠比沒有代謝症候群高許多，有研究顯示肥胖者體內促發炎細胞激素分泌量較高，但其引起發炎的病理角色則尚未完全清楚。本研究假說介白素-6、介白素-10扮演重要調控角色。因此本研究探討15個年齡平均41±11歲、身體質量指數平均30.3±3.5、腰圍平均101±8公分之腹部肥胖受試者，經8週運動與飲食減重課程介入後，其血清發炎調節因子脂締素(adiponectin)、介白素-6、介白素-10、腫瘤壞死因子-α (TNF-α)之變化，及其與代謝症候群指標變化之相關性，實驗結果顯示：受測者減重前，血清脂締素濃度與體重、身體質量指數(BMI)、瘦體組織、皮下脂肪、體脂肪、腰圍呈負相關。血清IL-6濃度與BMI、皮下脂肪、內臟脂肪、腰圍、體脂肪呈正相關。血清TNF-α濃度與高密度脂蛋白(HDL)呈負相關，與收縮血壓呈正相關。血清IL-10濃度與其他檢測值則無明顯相關。減重前受測者中代謝症候群者(MS組)血中三酸甘油酯(TG)濃度明顯大於非代謝症候群(non-MS組)(P=0.013)；血清IL-6濃度則是non-MS組大於 MS組 (P＝0.053)；其它數值則無明顯差異；但減重後，non-MS組IL-10與TNF-α濃度增加，MS組TNF-α濃度下降，兩組TNF-α有明顯不同之改變(P< 0.05)。在減重變化，MS組在體重、BMI、肌肉、TG、TC/HDL、TNF-α血清濃度經減重後皆明顯下降(P<0.05)，腰圍亦下降(P<0.01)。non-MS組在體重、BMI、瘦體組織、HDL、膽固醇、腰圍皆明顯下降(P<0.01)，皮下脂肪亦下降(P<0.05)，但TNF-α濃度則上升(P<0.05)，其餘數值則無明顯改變。在減重前後各項數值變化差異方面，BMI、體重、瘦體組織改變數值，MS與non-MS兩組皆顯著下降，但下降變化兩組之間並無差異；腰圍減少方面，non-MS組明顯比MS組下降多(P<0.05)；空腹血糖、TG、TC/HDL、TNF-α變化數值則為non-MS上升，MS組則下降，兩組有明顯差異(P<0.05)；adiponectin變化數值為 MS組上升，non-MS組下降，此變化值兩組亦有明顯差異(P=0.045)。 綜合本研究結果:在經8週運動與飲食減重課程介入後，MS組與 non-MS組之BMI、體重、腰圍皆顯著下降；TG、TC/HDL、TNF-α變化MS組下降較顯著，推測應有利於降低心血管疾病。血清發炎調節因子adiponectin變化數值為 MS組上升，non-MS組下降；IL-10血清濃度 non-MS組增加，MS組仍無法測得；TNF-α變化數值則為non-MS組上升，MS組下降。顯示腹部肥胖MS與non-MS組在減重過程有顯著不同反應趨勢。

Metabolic syndromes (MS) are linked with central obesity and may cause cardiovascular diseases (CVD). Pro-inflammatory molecules are suggested to play an important role in developing metabolic syndromes; however the pathological role is still not quietly verified. We hypothesized the IL-6 and IL-10 may perform an important control role. The aim of this study was to analyze the effects of an 8-week weight control program on serum inflammatory markers and risk factors for metabolic syndromes in 15 android obese subjects (average age, 41±11;BMI, 30.3±3.5) including 6 MS and 9 non-MS individuals. The results showed that before the weight control program was administrated, serum adiponectin concentration showed statistically negative correlations with BMI, weight, lean body mass, body fat, subcutaneous fat, and waist circumference. A significantly negative correlation existed between serums TNF-α and high density lipoprotein cholesterol (HDL-C) concentration, but a statistically positive correlation existed between serums TNF-α and blood pressures (Bps). Serum IL-6 concentration exhibited statistically positive correlations with the BMI, visceral fat, body fat, subcutaneous fat, and waist circumference. There was no significant correlation among these parameters and IL-10. TG concentration in MS subjects was significantly higher than those in non-MS subjects (P＝0.013). Serum IL-6 concentration in non-MS subjects was significantly higher than those in MS subjects (P＝0.053), however the other data were not significantly different between MS and non-MS subjects. 2) After the weight control program, the BMI, weight, lean body mass, TG, TC/HDL ratio, and TNF-α in MS subjects were significantly improved. In non-MS subjects, the BMI, weight, lean body mass, cholesterol, and waist circumference were also significantly improved. However, the improvement on indicators for metabolic syndromes in non-MS subjects was better than those in MS subjects. The concentration of IL-10 and TNF-α were significantly differential between MS and non-MS subjects (P<0.05). 3) The net changes in fasting glucose, TG, TC/HDL, TNF-α increased in non-MS subjects through the weight control program, whereas the net changes of these markers decreased in MS subjects. The net adiponectin change increased in MS subjects, but decreased in non MS subjects. In conclusion, the net changes of these indicators in MS and non-MS subjects were significantly different. As the weight control program was finished. The weight, BMI, and waist circumference in subjects with android obesity were indeed improved. The improvement on net variances of TG, TC/HDL, and TNF-α in MS subject was significant. Although the changes of adiponectin, IL-6, IL-10, and TNF-α were different between MS and non-MS subjects, the results from this study suggest that weight control may be beneficial to reduce CVD diseases via improving the indicators for metabolic syndromes.