관상동맥경화증인 과체중 남성에서 열량제한과 Testosterone 투여가 체지방 분포 및 혈청 지질 농도에 미치는 영향

Abstract

In middle-aged men, abdominal obesity has been an important risk factor of coronary artery disease (CAD) as well as a predictor of hypertension, dyslipidemia, insulin resistance and glucose intolerance. Particularly, risks from abdominal obesity increase when adipose tissue accumulates in visceral compartment. Many studies showed that weight reduction by caloric restriction improves abdominal obesity and reduces lots of cardiovascular risk factors. Testosterone treatment also results in a significant decrease in visceral fat area and normalizes endocrine metabolism. However there is no study that compare the effect of caloric restriction with that of testosterone treatment. The purpose of this study is to investigate the effect of caloric restriction and that of testosterone treatment on body fat distribution, serum lipids and glucose metabolism in male patients with CAD. Forty five middle-aged overweight-obese men with CAD participated in 12 weeks' program. They were matched with age, body weight, body mass index (BMI) and divided into three groups : control group (n = 15) , caloric restriction group (-300 kcal/day, n = 15) and testosterone treatment group (testosterone undecanoate tablets, n = 15) . After 12 weeks, control group did not have any changes in anthropometries, lipid profile, body fat distribution, glucose metabolism and hormonal status. Expectedly, caloric restriction group showed decreases in body weight, BMI, waist to hip ratio, ％ body fat. Ten percentage of total cholesterol and 23% of triglyceride in serum were also decreased. In body fat distribution, total fat areas at both L1 and L4 levels were significantly reduced in this group without reduction in muscle of thigh and calf. However, testosterone treatment group did not have any significant changes in body weight, ％ body fat, serum lipid profile and abdominal fat distribution. In conclusion, weight reduction by caloric restriction is more beneficial in body fat distribution and serum lipid level than testosterone treatment in overweight male patients with CAD. This result suggests that modest weight reduction is possible to help decrease risk factors of CAD.