目的 探讨益生菌联合低血糖生成指数(GI)高优质蛋白饮食干预对肥胖患者肌肉量、脂肪量和握力的作用及机制 分析。 方法 选取 2024 年 7 月至 12 月南方医科大学深圳医院临床营养科就诊的肥胖患者 110 例,采用随机数字表法随机分为 干预组(n = 55)和对照组(n = 55),所有肥胖患者在膳食调查基础上制订个性化低 GI 高优质蛋白饮食干预方案,其中热量为 20 kcal / (kg·d),蛋白质占总热量的 30%,碳水化合物占 40%,脂肪占 30%,膳食纤维 14g / d,干预组在饮食干预基础上额外给 予益生菌制剂,比较干预前后 8 周体重和体成分的变化,并记录胃肠道不良反应。 结果 干预前两组体重、体质指数、肌肉量、 握力等无差异(P> 0. 05),干预后两组体重均有下降(P< 0. 05),干预组体重减轻(6. 14± 4. 00) kg,高于对照组的( - 4. 43± 3. 19)kg(P<0. 05),并且干预组肌肉丢失量小于对照组 [(-1. 35±1. 48)kg 比 (-2. 31±1. 74)kg,P<0. 05],而脂肪丢失量大于 对照组,男女亚组分析均显示一致的保护肌肉效应,尤其是干预后女性握力明显大于对照组(P = 0. 032),男性亚组未见到明 显差异。 益生菌可以减少减重过程中便秘发生率(P= 0. 031),并无其他严重不良反应。 结论 益生菌联合低 GI 高优质蛋白饮 食干预可有效降低肥胖患者体重、体脂肪量,并可能通过肠-肌轴保护减重过程中的肌肉和力量。

Objective To explore the effects and analysis of probiotics combined with low glycemic index GI and high-quality protein diet intervention on muscle mass fat mass and grip strength in obese patients. Method A total of 110 obese patients who attended the Department of Clinical Nutrition Shenzhen Hospital of Southern Medical University from July to December 2024 were selected and randomly divided into an intervention group n = 55 and a control group n = 55 using the random number table method. All obese patients received an individualized low GI and high-quality protein diet which includes an energy intake of 20 kcal / kg·d energy ratio of 30% for protein 40% for carbohydrates and 30% for fat and dietary fiber intake of 14 g / d. The intervention group was given an additional probiotic preparation besides the dietary intervention for 8 weeks. The changes of body weight and body composition after the intervention were compared. All gastrointestinal adverse reactions were recorded. Result There was no significantly difference in body weight body mass index muscle mass and grip strength between the two groups at the baseline P > 0. 05 . After the intervention the body weight of both groups decreased P<0. 05 . The weight loss of the intervention group was -6. 14±4. 00 kg which was higher than that of the control group -4. 43±3. 19 kg P<0. 05 . Moreover the muscle loss in the intervention group was less than that in control group - 1. 35± 1. 48 kg vs - 2. 31± 1. 74 kg P < 0. 05 while the fat loss was greater. The analysis of both male and female subgroups showed a consistent muscle protection effect. Especially after the intervention the grip strength of females was significantly greater than that of control group P = 0. 032 . Probiotics can reduce the incidence of constipation during the intervention P = 0. 031 and there are no other serious adverse events. Conclusion The intervention of probiotics combined with a low-GI and high-quality protein diet can effectively reduce the weight body fat mass of obese patients and may protect the muscles and strength during the weight loss process through the gut-muscle axis.