目的:探讨不吃早餐对肥胖个体的体重、代谢指标、食欲调节及炎症因子的影响.方法:以医院内分泌科检测的60例单纯性肥胖人群(IBM>28kg/m2)为研究对象,实验分为提供标准早餐的对照组(n=30),及禁食至中午11:30的早餐禁食组(n=30),在实验开始之前及3周禁食后,记录身高、体重等生理指标,采血检测血糖血脂等相关代谢指标,及分离血清检测食欲调节激素及炎性因子,每日记录每人的能量摄入.结果:实验开始前的两组指标之间并没有明显的差别.经过3周的处理,两组体重未出现明显差异,总能量摄入量早餐禁食组低于对照组,但不显著.两组血糖无明显差异,相对于对照组,早餐禁食组血胰岛素明显上升,胰岛素敏感指数出现明显下降;早餐禁食组LDL-胆固醇显著上升;早餐禁食组酪酪肽出现明显下降,胃饥饿素及炎性因子没有显著变化.结论:早餐禁食并不会减少体重,反而会导致胰岛素敏感性的下降,LDL-C的上升,此外食欲激素的改变和在非早餐时段摄入更多的能量表明,早餐禁食很可能改变了肥胖人群的食欲,出现能量补偿效应.%Objective To explore the effect of breakfast skipping on body weight, metabolic index, appetite and inflamma-tion index of simple obesity patients. Methods 60 simple obesity patients with comparable body weights and BMI were enrolled in our study and randomly divided into two groups: breakfast group and fasting group. Before and after the experiment, we took record of the height, body weight and took the fasting blood samples to test the blood glucose, insulin, lipids and PYY, ghre-lin, IL-6 and TNF-α. The energy consumption were recorded daily during the experiment. Results Breakfast skipping didn' t change the body weights between two groups. However, the fasting group took in nearly similar daily energy with breakfast group. Fasting group had higher insulin concentration and lower insulin activity index. Fasting groups had higher LDL-c, show-ing higher potential risk in cardiovascular risk. Significantly lower PYY in serum were detected in fasting group. There's no significant difference in inflammation index IL-6 and TNF-α between two groups. Conclusion In obese adults, breakfast fast-ing results in higher insulin activity index and LDL-c. Breakfast fasting results in dietary compensation with higher appetite evaluation.
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