血清瘦體素濃度對減重成效的影響

本研究的目的主要是探討血清瘦體素濃度與減重成效的相關性和復胖的關係。受試者分為兩組，減重組 (27<BMI<35) 和控制組（ 18.5 BMI<24≦ ）。減重組提供 8 週低熱量飲食 (1200 大卡 / 天：醣類： 55 % ，脂肪： 20 % ，蛋白質： 25 %) ，實驗結束後 3 個月，追蹤其體組成和血液生化值的改變。控制組 (n=18; 女性 16 位、男性 2 位 ) 平均年齡 25 ± 0.8 歲、身體質量指數 20.2 ± 0.3 公斤 / 公尺 2 以及體脂肪百分比為 24.7 ± 1.3 % 。減重組（ n=18 ；女性14 位、男性 4 位）平均年齡 39 ± 1.7 歲、身體質量指數 28.2 ± 3.3 公斤 / 公尺2 以及體脂肪百分比為 33.1 ± 1.5 % 。減重組年齡、體重、身體質量指數、除脂體重、脂肪重、肌肉重、體脂肪百分比、腰臀比、血糖、總膽固醇、三酸甘油酯、低密度脂蛋白膽固醇濃度、總膽固醇 / 高密度脂蛋白膽固醇比值、瘦體素以及胰島素濃度均顯著大於控制組，高密度脂蛋白膽固醇濃度顯著低於控制組。減重 4 週和 8 週後，體重、脂肪重、肌肉重、身體質量指數、身體總水重、蛋白質重、基礎代謝速率、體脂肪百分比、瘦體素以及胰島素濃度均顯著的降低，但減重 8 週後，腰臀比均顯著的降低。追蹤三個月後，體重、脂肪重、身體質量指數、腰臀比、瘦體素以及促甲狀腺素濃度均顯著的增加。在血清瘦體素濃度與體重變化的相關性方面， 4 週和 8 週後體重變化均與基礎血清瘦體素濃度和基礎血清瘦體素濃度 / 身體質量指數呈顯著的正相關；追蹤三個月體重與基礎血清瘦體素濃度和基礎血清瘦體素濃度 / 身體質量指數無相關性。因此，減重期間，肥胖者基礎血清瘦體素濃度越高，可以減輕較多的體重，且基礎血清瘦體素濃度可以預測減重的成效，但是基礎血清瘦體素濃度不能預測體重的回復。

Effects of serum leptin concentrations on effectiveness of weight loss

The purpose of this study was to assess the correlation serum leptin concentration with effectiveness of weight loss. The study was divided into two groups, one was weight loss group and another was control group. In the weight loss group, we were provided with 1200 Kcal/day (CHO: 55 %, FAT: 20 %, PRO: 25 %) for 8 weeks. After three months, we followed body composition and biochemical measurements changes. In the control group, subjects (n = 18, male = 2, female = 16) aged 25 ± 0.8 yrs, body mass index was 20.2 ± 0.3 kg/m2, body fat mass percentage was 24.7 ± 1.3 %. In the weight loss group, subjects (n = 18, male = 4, female = 14) aged 39 ± 1.7 yrs, body mass index was 28.2 ± 3.3 kg/m2, body fat mass percentage was 33.1 ± 1.5 %. The weight loss group which age, weight, BMI, fat free mass, muscle mass, body fat mass percentage, waist-hip ratio, blood sugar, total cholesterol, triacylglyceride, LDL-C and TC/HDL-C were significantly higher than control group (p < 0.05). After 4 and 8 weeks weight loss program, weight, fat mass, muscle mass, BMI, total body water, protein weight, basal metabolic rate, body fat percentage, serum leptin and insulin concentration significantly decreased (p < 0.05). But after 8 weeks weight loss program, waist-hip ratio significantly decreased (p < 0.05). After 3 months follow-up, weight, fat mass, BMI, waist-hip ratio, serum leptin and TSH concentration increased significantly (p < 0.05). The 4 and 8 weeks weight changes significantly positive correlated with baseline leptin concentration and baseline leptin/BMI, but the 3 months follow-up weight changes no significantly correlated with baseline leptin concentration and baseline leptin/BMI. Therefore, during weight loss program, subjects who lose more weight have higher baseline leptin concentration and baseline leptin concentration predicted subsequently weight loss. But baseline leptin concentration failed to predicted weight regain.