nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-194-10-118-125nogr-1767Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYЭффективность диетотерапии у пожилых с ожирением и неалкогольной жировой болезнью печениEvaluation of the effectiveness of diet therapy in the elderly with obesity and non-alcoholic fatty liver diseasehttps://orcid.org/0000-0002-0963-0792ЛапикИ. А.LapikI. A.

Лапик Ирина Александровна – кандидат медицинских наук, научный сотрудник отделения реабилитационной диетотерапии.

115446, Москва, Каширское шоссе, 21.

Irina A. Lapik – PhD.

21, Kashirskoeshosse, Moscow, 115446.

eLibrary SPIN: 2927-2441

Lapik_@inbox.ruhttps://orcid.org/0000-0002-5053-9042ЧехонинаЮ. Г.ChekhoninaY. G.

Чехонина Юлия Геннадьевна - кандидат медицинских наук, старший научный сотрудник отделения реабилитационной диетотерапии.

115446, Москва, Каширское шоссе, 21.

Yulia G. Chekhonina – PhD.

21, Kashirskoeshosse, Moscow, 115446.

eLibrary SPIN: 3181-6767

https://orcid.org/0000-0002-3684-9992КоротковаТ. Н.KorotkovaT. N.

Короткова Татьяна Николаевна - кандидат медицинских наук, заведующая лабораторией клинической биохимии, иммунологии и аллергологии.

115446, Москва, Каширское шоссе, 21.

Tatiana N Korotkova – Dr.

21, Kashirskoeshosse, Moscow, 115446.

eLibrary SPIN: 6502-3727; ID: 1050613

https://orcid.org/0000-0003-1223-8545ГаппароваК. М.GapparovaK. M.

Гаппарова Камилат Минкаиловна - кандидат медицинских наук, заведующая отделением реабилитационной диетотерапии.

115446, Москва, Каширское шоссе, 21.

Camilat M. Gapparova – PhD.

21, Kashirskoeshosse, Moscow, 115446.

eLibrary SPIN: 3394-4039

Федеральный исследовательский центр питания, биотехнологии и безопасности пищиРоссияFederal Research Centre of Nutrition, Biotechnology and Food SafetyRussian FederationФедеральный исследовательский центр питания, биотехнологии и безопасности пищи; Российский национальный исследовательский медицинский университет им. Н. И. Пирогова Минздрава РоссииРоссияFederal Research Centre of Nutrition, Biotechnology and Food Safety; N.I. Pirogov Russian National Research Medical UniversityRussian Federation202123122021010118125Copyright © Лапик И.А., Чехонина Ю.Г., Короткова Т.Н., Гаппарова К.М., 20212021Лапик И.А., Чехонина Ю.Г., Короткова Т.Н., Гаппарова К.М.Lapik I.A., Chekhonina Y.G., Korotkova T.N., Gapparova K.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1767

Целью исследования явилась оценка эффективности стандартной диеты с пониженной калорийностью у лиц пожилого возраста с ожирением и неалкогольной жировой болезнью печени (НАЖБП).

Материалы и методы

Материалы и методы: Обследовано 60 женщин с ожирением I-III степени и НАЖБП. Пациентам проведена оценка метаболического статуса методом непрямой калориметрии, показателей состава тела с использованием биоимпедансометрии. Биохимические показатели в сыворотке крови определяли на биохимическом анализаторе «KONELAB Prime 60i». Для статистической обработки данных использовали программу SPSS Statistics 23,0.

Результаты и обсуждение

Результаты и обсуждение: Установлено, что энерготраты покоя у женщин среднего возраста (1896,8±46,5 ккал/сут) с ожирением и НАЖБП достоверно выше, чем у женщин пожилого возраста (1691,6±34,2 ккал/сут). Скорость окисления жиров достоверно ниже у женщин пожилого возраста (66,8±7 г/сут), чем у женщин среднего возраста (70,8±9 г/сут). Пациенты пожилого возраста в течение 10 дней получали вариант стандартной диеты с пониженной калорийностью. На фоне диетотерапии у пациентов пожилого возраста с ожирением и НАЖБП наблюдалось достоверное снижение глюкозы, общего холестерина, ЛПНП, триглицеридов, а также жировой массы, общей жидкости и площади висцерального жира. Однако применение стандартной диеты с пониженной калорийностью привело к незначительному подъему уровня мочевой кислоты в сыворотке крови и достоверному снижению мышечной массы тела.

Заключение

Заключение: при назначении диетотерапии пациентам пожилого возраста с ожирением и НАЖБП рекомендован подбор специализированных рационов, что позволит не только предотвратить снижение мышечной массы и повышение мочевой кислоты, но и улучшить эффективность лечебных мероприятий при ожирении, предотвратив развитие и прогрессирование его осложнений.

The aim of the study was to evaluate the effectiveness of a standard reduced-calorie diet in elderly subjects with obesity and nonalcoholic fatty liver disease (NAFLD).

Materials and Methods

Materials and Methods: 60 women with I-III degree obesity and NAFLD were examined. Metabolic status was assessed by indirect calorimetry and body composition indices using bioimpedance spectroscopy. Biochemical indices in blood serum were determined on a biochemical analyzer “KONELAB Prime 60i”. SPSS Statistics 23.0 program was used for statistical data processing.

Results and Discussion

Results and Discussion: It was found that resting energy expenditure was significantly higher in middle-aged women (1896.8±46.5 kcal/d) with obesity and NAFLD than in elderly women (1691.6±34.2 kcal/d). Fat oxidation rate was significantly lower in elderly women (66.8±7 g/day) than in middle-aged women (70.8±9 g/day). The elderly patients received a variant of the standard diet with reduced caloric content for 10 days. Against the background of diet therapy, a significant decrease in glucose, total cholesterol, LDL, triglycerides, as well as fat mass, total fluid and visceral fat area was observed in elderly patients with obesity and NAFLD. However, the use of a standard reduced-calorie diet resulted in a slight elevation of serum uric acid levels and a significant decrease in muscle mass.

Conclusions

Conclusions: the selection of specialized diets is recommended for elderly patients with obesity and NAFLD when prescribing diet therapy, which will not only prevent the decrease of muscle mass and increase of uric acid but also improve the effectiveness of treatment measures in obesity by preventing the development and progression of its complications.

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The authors declare that there are no conflicts of interest present.