【摘要】：研究背景和目的：全世界大約1／5的兒童肥胖或超重。然而,目前尚缺乏有效的干預(yù)措施。因?yàn)閮和砷L(zhǎng)發(fā)育之需,節(jié)食的方法不合適。兒童缺少對(duì)常規(guī)鍛煉的依從性,難以行之有效。目前也沒(méi)有有效的減肥藥�？s胃手術(shù)因并發(fā)癥還不能常規(guī)開(kāi)展。綜合考慮,調(diào)整能量攝入似乎成為治療兒童肥胖的曙光。高蛋白飲食可能會(huì)有減肥作用。本研究的目的在于探討高蛋白早餐對(duì)相應(yīng)的午餐攝入量、食欲激素在肥胖青少年中的影響,旨在為有效治療兒童肥胖提供可行性策略。 方法和材料：本研究共入選一百五十六名肥胖青少年,男性80名,女性76名,平均年齡在14歲左右,體重約58公斤,體重指數(shù)(BMI)約32kg/m2,隨機(jī)地分配到同等熱量的早餐組,或?yàn)殡u蛋組(n=81),或?yàn)轲z頭組(n=75)。本研究包括兩個(gè)分課題：第一分課題兩次測(cè)試間隔為1周；第二分課題兩次測(cè)試間隔為3個(gè)月。測(cè)試當(dāng)天,受試者首先接受一般檢查,包括體重,身高,VAS,空腹血采集等。各受試者予以相同熱量早餐。之前及之后30、60、120、180分鐘時(shí)分別以VAS判斷其饑飽程度。之前和之后30和180分鐘分別采血以放射免疫分析法測(cè)定飽食激素多肽YY (PYY)和胰高血糖素樣肽-1以及饑餓激素(ghrelin)。四小時(shí)后,予以標(biāo)有熱卡的自助餐,并記錄攝入量。測(cè)試后受試者回家。囑咐其進(jìn)食與在參加測(cè)試時(shí)類似的早餐并記錄攝入量。測(cè)試分別予一周及3月后重復(fù)。統(tǒng)計(jì)分析分別在測(cè)試間、組問(wèn)進(jìn)行比較。Pearson相關(guān)系數(shù)進(jìn)行相關(guān)性分析。 結(jié)果：第一分課題部分：兩測(cè)試問(wèn)無(wú)差異,雞蛋組和饅頭組比較,體重變化無(wú)差異,但雞蛋組受試者在進(jìn)早餐后3小時(shí)時(shí)饑餓感不明顯,這與其PYY水平的增加相一致。第二分課題部分：兩測(cè)試問(wèn)無(wú)差異,但兩組間比較,雞蛋組受試者體重減輕明顯(3.9%vs.0.2%,p0.001)。這與兩組間午餐食物攝入量相關(guān)(r=-0.76,p0.001)：雞蛋組受試者午餐攝入量明顯少于饅頭組受試者(451vs.567kcal)。早餐后2、3小時(shí),兩組受試者饑餓和飽足感差異明顯,雞蛋組受試者飽足感明顯,饑餓不著(p0.001)。并且,體重的變化與食欲激素水平的變化相關(guān)：早餐后3小時(shí),雞蛋組受試者PYY水平明顯增高(66%vs.18%,p0.001),并且,其增加與體重的減輕成正相關(guān)(r=0.89,p0.001)。雞蛋組受試者GLP-1水平3小時(shí)后也明顯高于饅頭組(6.6%vs.1.1%,p0.001),并且,其增加與體重的減輕成正相關(guān)(r=0.78,p0.001)。饑餓激素ghrelin在饅頭組受試者中降低更明顯(30分鐘后-1.1%vs.20.6%,p0.001；180分鐘后-5.9%vs.-15.1%,p0.001),并且這與體重的減輕成負(fù)相關(guān)(r=-0.76,p0.001)。 結(jié)論：高蛋白早餐有助青少年減肥,可能是通過(guò)其對(duì)飽食感、食物攝入量以及對(duì)食欲激素的調(diào)節(jié)而達(dá)到的。
[Abstract]:Background and objective: about a fifth of the world's children are obese or overweight. However, there is a lack of effective interventions. Because children need to grow up, dieting method is not suitable. Children lack compliance with regular exercise and are difficult to be effective. There is also no effective diet medicine. Gastric contractions can not be performed routinely because of complications. Taken together, adjusting energy intake seems to be the dawn of childhood obesity. A high-protein diet may have a weight loss effect. The purpose of this study was to explore the effects of high protein breakfast on the corresponding intake of lunch and the effect of appetite hormone on obese adolescents in order to provide feasible strategies for the effective treatment of obesity in children. Methods and materials: a total of 156 obese adolescents, 80 males and 76 females, were enrolled in this study. The average age was about 14 years old, the weight was about 58 kg, and the body mass index (BMI) was about 32 kg / m2. They were randomly assigned to the same caloric breakfast group, either egg group (ncai 81) or steamed bread group (n + 75). This study consists of two subtopics: the first one is one week interval and the second is 3 months. On the day of the test, the subjects underwent general examinations, including weight, height, VAS, fasting blood collection and so on. All subjects were given the same calorie breakfast. VAS was used to determine the degree of hunger and satiety before and after 30g 60120180 minutes. Before and after 30 and 180 minutes, blood samples were collected for the determination of satiety hormone peptide YY (PYY), glucagon like peptide-1 and hunger hormone (ghrelin). By radioimmunoassay. Four hours later, a hot-calorie buffet was given and intake was recorded. The subjects went home after the test. Instruct them to eat breakfast that is similar to the one they took at the time of the test and record their intake. The test was repeated one week and three months later. The statistical analysis was compared between the test groups. The correlation coefficient of Pearson was analyzed. Results: in the first part, there was no difference between the two groups. There was no difference in body weight between egg group and steamed bread group, but the hunger feeling of egg group was not obvious at 3 hours after breakfast, which was consistent with the increase of PYY level. The second part: there was no difference between the two groups, but compared with the two groups, the egg group had significant weight loss (3.9vs.0.2g / p0.001). This was correlated with the intake of food for lunch between the two groups (r-0.76, p0.001): the intake of lunch in the egg group was significantly lower than that in the steamed bread group (451vs.567kcal). There were significant differences in hunger and fullness between the two groups at 2h after breakfast, but not between the egg group and the egg group (p0.001). In addition, weight changes were correlated with changes in appetite hormone levels: PYY levels in the egg group were significantly higher than those in the egg group at 3 hours after breakfast (66vs.18g, p0.001), and the increase was positively correlated with weight loss (r = 0.89, r = 0.89). P0.001) The GLP-1 level of egg group was also significantly higher than that of steamed bread group after 3 hours (6.6vs.1.1), and its increase was positively correlated with weight loss (r = 0.78p 0.001). The hunger hormone ghrelin was significantly decreased in the steamed bread group (30 minutes later, -1.1 vs.20.6, p0.001; 180 minutes later, -5.9 vs. -15.1and negatively correlated with weight loss (r-0.76p0.001). Conclusion: high protein breakfast can help adolescents lose weight, possibly through the regulation of satiety, food intake and appetite hormone.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R723.14

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李志玲;徐珞;;Nesfatin-1對(duì)大鼠下丘腦弓狀核ghrelin敏感性胃牽張神經(jīng)元放電及胃運(yùn)動(dòng)的調(diào)控[J];青島大學(xué)醫(yī)學(xué)院學(xué)報(bào);2014年02期

2 李利輝;陳凱東;竇汝香;;甲狀腺功能亢進(jìn)癥患者血漿Ghrelin水平的變化及其影響因素[J];海南醫(yī)學(xué)院學(xué)報(bào);2014年02期

3 Mingcheng WANG;Enzhong LI;Gailing WANG;;Histopathological Analysis of Liver During Pregnancy Toxemia in Small-tailed Han Sheep[J];Agricultural Science & Technology;2014年03期

4 王娟;衛(wèi)紅;趙景志;李琳琳;尹磊;張功員;劉衛(wèi)剛;暴磊;;河南農(nóng)村肥胖成年人酪酪肽基因rs2880416位點(diǎn)多態(tài)性分析[J];鄭州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2014年04期

5 譚思榮;高冰;陶毅;蘇政權(quán);;辣椒堿減肥活性及機(jī)理研究進(jìn)展[J];食品研究與開(kāi)發(fā);2012年11期

6 李麗;;生活方式與體重相關(guān)激素調(diào)控研究[J];社區(qū)醫(yī)學(xué)雜志;2013年20期

7 陸希;崔焱;丁亞萍;李秀云;;社區(qū)2型糖尿病病人膳食現(xiàn)況調(diào)查[J];護(hù)理研究;2014年04期

8 王迪銘;劉建新;;肝臟氧化調(diào)節(jié)因子及其對(duì)動(dòng)物采食調(diào)節(jié)機(jī)制的研究進(jìn)展[J];中國(guó)奶牛;2013年19期

9 吳偉萍;陳捷;;飲食護(hù)理干預(yù)對(duì)肥胖兒童胃腸道激素的影響[J];中國(guó)農(nóng)村衛(wèi)生事業(yè)管理;2013年12期

10 許建萍;肖新華;;胰高血糖素樣肽-1的生理作用及分泌調(diào)節(jié)因素[J];中華臨床醫(yī)師雜志(電子版);2013年24期

相關(guān)博士學(xué)位論文 前4條

1 胡榮寬;天然產(chǎn)物銀線草醇對(duì)哺乳動(dòng)物細(xì)胞糖脂代謝的調(diào)控作用研究[D];中國(guó)科學(xué)技術(shù)大學(xué);2013年

2 劉闖;日糧蛋白質(zhì)水平對(duì)大鼠體脂含量的影響及其機(jī)制的研究[D];中國(guó)農(nóng)業(yè)大學(xué);2014年

3 郭曉娟;慢性個(gè)體化胃電刺激的參數(shù)篩選及其對(duì)犬?dāng)z食、體重、胃腸激素及胃排空的影響[D];北京協(xié)和醫(yī)學(xué)院;2014年

4 鄒文利;不同飲食對(duì)SD大鼠腸道代謝產(chǎn)物和食欲調(diào)控因子的影響[D];中南大學(xué);2014年

相關(guān)碩士學(xué)位論文 前10條

1 彭煥文;南方鲇orexin和CART基因cDNA克隆分析及其mRNA表達(dá)初步研究[D];西南大學(xué);2013年

2 陳景葳;急性熱應(yīng)激對(duì)番鴨和蛋鴨NPY、NPY5R及CCK基因表達(dá)的影響[D];南京農(nóng)業(yè)大學(xué);2011年

3 熊海霞;武定雞NPY基因、IGF-1基因多態(tài)性與產(chǎn)蛋性能關(guān)系的研究[D];云南農(nóng)業(yè)大學(xué);2013年

4 李志玲;下丘腦PVN-ARC Nesfatin-1神經(jīng)通路構(gòu)成及對(duì)胃牽張敏感神經(jīng)元放電活動(dòng)和胃運(yùn)動(dòng)調(diào)控研究[D];青島大學(xué);2014年

5 李麗;Ghrelin對(duì)糖尿病大鼠攝食的影響及機(jī)制研究[D];青島大學(xué);2013年

6 喬靜;Exendin-4干預(yù)對(duì)2型糖尿病腎病大鼠腎組織HO-1及NT表達(dá)的影響[D];山西醫(yī)科大學(xué);2014年

7 郭超凡;生酮飲食治療急性脊髓損傷的安全性和可行性初步觀察[D];南方醫(yī)科大學(xué);2014年

8 譚思榮;殼聚糖微球體內(nèi)分布及載辣椒堿微球藥動(dòng)學(xué)研究[D];廣東藥學(xué)院;2013年

9 陳麗云;GLP-1及其類似物對(duì)高糖環(huán)境下人臍靜脈內(nèi)皮細(xì)胞功能的保護(hù)作用及可能機(jī)制[D];福建醫(yī)科大學(xué);2014年

10 馬煥班;豬脂肪沉積性狀的全基因組關(guān)聯(lián)分析和一個(gè)位置候選基因IRS4的相關(guān)研究[D];江西農(nóng)業(yè)大學(xué);2014年

，

本文編號(hào)：2372244