运动结合饮食干预对肥胖青少年血清脂肪酸组分和身体成分的影响及其相关性研究

目的：探索4周运动结合饮食干预对肥胖青少年的血清脂肪酸组分和身体成分的影响，同时分析脂肪酸基础值与身体成分相关指标变化量的相关性。方法：以2017年暑期参加皓千体育发展有限公司全封闭减肥训练营的25名肥胖青少年为研究对象（平均年龄：15.96±1.88y；平均BMI：32.66±4.51 kg/m²），进行为期4周的联合运动结合饮食干预，干预前后测试并分析身体成分、身体形态和血清脂肪酸组分的变化及其相互关系。结果：4周后，受试者的体重、身体质量指数（BMI）、体脂量、脂肪质量指数（FMI）、四肢脂肪量、腰围、臀围和腰臀比均显著降低，瘦体重%显著增加（P<0.001）；血清饱和脂肪酸（SFA）中，总饱和脂肪酸（SFAs）、肉豆蔻酸（C14：0）、十五烷酸（C15：0）、棕榈酸硬（C16：0）、脂酸（C18：0）、花生酸（C20：0）、山萮酸（C22：0）、二十三烷酸（C23：0）和二十四烷酸（C24：0）含量均显著降低（P<0.05）；单不饱和脂肪酸（MUFA）中，总单不饱和脂肪酸（MUFAs）、棕榈油酸（C16：1 n-7）、油酸（C18：1 n-9）和鳕油酸（C20：1 n-9）含量显著降低（P<0.01）；多不饱和脂肪酸（PUFA）中，总多不饱和脂肪酸（PUFAs）、总n-6多不饱和脂肪酸（n-6 PUFA）、亚油酸（C18：2 n-6）、二十碳二烯酸（C20：2 n-6）、双高-γ-亚麻酸（C20：3 n-6，DGLA）、花生四烯酸（C20：4 n-6，ARA）和α-亚麻酸（C18：3 n-3）显著下降（P<0.05）；Pearson相关性分析及一元线性回归分析表明，干预前血清C14：0与C20：3 n-6的基础值与体脂%及瘦体重%的变化量正相关，C16：1 n-7的基础值与体脂量、上肢脂肪量、右下肢脂肪量的变化量正相关（P<0.05）。结论：4周运动和饮食干预能明显改善肥胖患者身体成分、身体形态及血清脂肪酸组分；血清C14：0、C16：1 n-7、C20：3 n-6的基础值与身体成分的变化量存在线性关系，可以为减肥夏令营的饮食优化及减肥效果的预测提供参考。

Effect and Correlation Analysis of Exercise Combined with Dietary Intervention on Serum Fatty Acids and Body Composition in Obese Adolescents

The objective of this study was to explore the effect of exercise combined with dietary intervention on serum fatty acids and body composition in obese adolescents, and to analyze correlations between the baseline of serum fatty acids and the changes of body composition. 25 obese adolescents(age:15.96±1.88 years; BMI:32.66±4.51 kg/m²) volunteered to participate in the weight-loss program of Hao Qian Sports Development Company, and implemented the 4 weeks of exercise combined with dietary intervention. Body composition, shape and serum fatty acids were examined and assessed before and after the intervention. A significant decline was observed in weight, BMI, body fat, FMI, four limbs fat mass, waist circumference, hip circumference and waist/hip ratio, and the percentage of free fat mass was increased(P<0.001). In saturated fatty acid(SFA), total SFA, myristic acid(C14:0), pentadecanoic acid(C15:0), palmitic acid(C16:0), stearic acid(C18:0), arachidic acid(C20:0), behenic acid(C22:0), tricosanoic acid(C23:0) and lignoceric acid(C24:0) were significantly decreased(P<0.05). In monounsaturated fatty acid(MUFA), total MUFA, palmitoleic acid(C16:1 n-7), oleic acid(C18:1 n-9) and gadoleic acid(C20:1 n-9) declined(P<0.01). In polyunsaturated fatty acid(PUFA), total PUFA, n-6 PUFA, linoleic acid(C18:2 n-6), eicosadienoic acid(C20:2 n-6), dihomo-γ-linolenic acid(C20:3 n-6, DGLA), arachidonic acid(C20:4 n-6, ARA) and α-linolenic acid(C18:3 n-3) were remarkably decreased(P<0.05). Pearson correlation analysis and linear regression analysis showed that the baseline of C14:0、C20:3 n-6 was positively related to the percentage change of body fat and free fat mass, respectively. C16:1 n-7 was associated with the variation of body fat and limb fat mass(P<0.05). Conclusion:4-week exercise in combination with diet intervention could effectively improve the body composition、shape and serum fatty acids in obese adolescents; Basic levels of serum C14:0, C16:1 n-7 and C20:3 n-6 were associated with the variation of body composition in an anti-obesity program for adolescents, and this could provide a theoretical basis for program's diet optimization and prediction of the effect of weight loss.