Walker K Z, O'Dea K, Nicholson G C
Centre for Population Health and Nutrition, Monash University, Monash Medical Centre, Melbourne, Australia.
Eur J Clin Nutr. 1999 Sep;53(9):700-5. doi: 10.1038/sj.ejcn.1600835.
To compare effects of a high carbohydrate (high-CHO) and a monounsaturated fat diet (high-MUFA) on body fat distribution and sex hormones in post-menopausal women with Type 2 diabetes.
Randomised cross-over with no washout.
Geelong Hospital outpatient.
Thirty four women were recruited, 30 completed the study, and data are presented for 21 women compliant to the high-CHO diet.
Women followed a high-CHO diet (20% energy (%E) from fat, 60%E from carbohydrate and a high-MUFA diet (40%E from fat, half as monounsaturated fat, 40%E from carbohydrate) in random order for 12 weeks each.
Dietary compliance was measured by change in linoleic acid (C18:2,omega-6) in plasma cholesteryl esters. Body composition was measured by dual-energy X-ray absorptiometry. Fasting concentrations of glucose and insulin were measured in plasma. Steroid hormones and sex hormone binding globulin (SHBG) were measured in serum.
On the high-CHO diet C18:2,omega-6 in plasma cholesteryl esters declined by 5.4% (95% confidence intervals (CI), -2.5% to -8.4%, P=0.0015). Fat was lost mainly from the lower body (lower body loss -0.71 kg, 95%CI, -0.43 to -1.00 kg, P=0.001; upper body loss -0.15 kg, 95%CI, -0.76 to +0.46 kg, P=0.6). Yet on the high-MUFA diet, lower body fat loss was minimal (-0.22 kg, 95%CI, +0.11 to -0.55 kg, P = 0.2). By general linear modelling (GLM), differences in lower body fat loss were significantly related to diet (P = 0.04). After adjustment for age, dehydroepiandrosterone sulphate (DHEAS) concentrations after the high-CHO diet were related to levels of lower body fat (r = 0.394, P = 0.04).
In women with Type 2 diabetes following a high-CHO diet for 12 weeks the disproportionate loss of lower body fat is related to a decline in DHEAS.
比较高碳水化合物（高CHO）饮食和单不饱和脂肪饮食（高MUFA）对2型糖尿病绝经后女性身体脂肪分布和性激素的影响。
无洗脱期的随机交叉试验。
吉朗医院门诊。
招募了34名女性，30名完成了研究，本文呈现了21名遵循高CHO饮食女性的数据。
女性随机先后采用高CHO饮食（脂肪供能占20%（%E），碳水化合物供能占60%E）和高MUFA饮食（脂肪供能占40%E，其中一半为单不饱和脂肪，碳水化合物供能占40%E），每种饮食持续12周。
通过血浆胆固醇酯中亚油酸（C18:2，ω-6）的变化来衡量饮食依从性。采用双能X线吸收法测量身体成分。测量血浆中空腹血糖和胰岛素浓度。测量血清中的类固醇激素和性激素结合球蛋白（SHBG）。
在高CHO饮食期间，血浆胆固醇酯中的C18:2，ω-6下降了5.4%（95%置信区间（CI），-2.5%至-8.4%，P = 0.0015）。脂肪主要从下半身减少（下半身减少0.71kg，95%CI，-0.43至-1.00kg，P = 0.001；上半身减少0.15kg，95%CI，-0.76至+0.46kg，P = 0.6）。然而，在高MUFA饮食期间，下半身脂肪减少极少（-0.22kg，95%CI，+0.11至-0.55kg，P = 0.2）。通过一般线性模型（GLM）分析，下半身脂肪减少的差异与饮食显著相关（P = 0.04）。在调整年龄后，高CHO饮食后的硫酸脱氢表雄酮（DHEAS）浓度与下半身脂肪水平相关（r = 0.394，P = 0.04）。
2型糖尿病女性采用高CHO饮食12周后，下半身脂肪不成比例减少与DHEAS水平下降有关。
