魔芋甘露聚糖粘性膳食纤维对胰岛素抵抗综合征患者的有益作用：一项对照代谢试验的结果

Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial.

作者信息

Vuksan V, Sievenpiper J L, Owen R, Swilley J A, Spadafora P, Jenkins D J, Vidgen E, Brighenti F, Josse R G, Leiter L A, Xu Z, Novokmet R

机构信息

Department of Nutritional Sciences, St. Michael's Hospital, University of Toronto, Canada.

出版信息

Diabetes Care. 2000 Jan;23(1):9-14. doi: 10.2337/diacare.23.1.9.

DOI:10.2337/diacare.23.1.9

PMID:10857960

Abstract

OBJECTIVE

Dietary fiber has recently received recognition for reducing the risk of developing diabetes and heart disease. The implication is that it may have therapeutic benefit in prediabetic metabolic conditions. To test this hypothesis, we investigated the effect of supplementing a high-carbohydrate diet with fiber from Konjac-mannan (KJM) on metabolic control in subjects with the insulin resistance syndrome.

RESEARCH DESIGN AND METHODS

We screened 278 free-living subjects between the ages of 45 and 65 years from the Canadian-Maltese Diabetes Study. A total of 11 (age 55+/-4 years, BMI 28+/-1.5 kg/m2) were recruited who satisfied the inclusion criteria: impaired glucose tolerance, reduced HDL cholesterol, elevated serum triglycerides, and moderate hypertension. After an 8-week baseline, they were randomly assigned to take either KJM fiber-enriched test biscuits (0.5 g of glucomannan per 100 kcal of dietary intake or 8-13 g/day) or wheat bran fiber (WB) control biscuits for two 3-week treatment periods separated by a 2-week washout. The diets were isoenergetic, metabolically controlled, and conformed to National Cholesterol Education Program Step 2 guidelines. Serum lipids, glycemic control, and blood pressure were the outcome measures.

RESULTS

Decreases in serum cholesterol (total, 12.4+/-3.1%, P<0.004; LDL, 22+/-3.9%, P<0.002; total/HDL ratio, 15.2+/-3.4%, P<0.003; and LDL/HDL ratio, 22.2+/-4.1%, P< 0.002), apolipoprotein (apo) B (15.1+/-4.3%, P<0.0004), apo B/A-1 ratio (13.1+/-3.4%, P< 0.0003), and serum fructosamine (5.2+/-1.4%, P<0.002) were observed during KJM treatment compared with WB-control. Fasting blood glucose, insulin, triglycerides, HDL cholesterol, and body weight remained unchanged.

CONCLUSIONS

A diet rich in high-viscosity KJM improves glycemic control and lipid profile, suggesting a therapeutic potential in the treatment of the insulin resistance syndrome.

摘要

目的

膳食纤维最近因能降低患糖尿病和心脏病的风险而受到认可。这意味着它可能对糖尿病前期的代谢状况具有治疗益处。为验证这一假设，我们研究了在高碳水化合物饮食中添加魔芋甘露聚糖（KJM）纤维对胰岛素抵抗综合征患者代谢控制的影响。

研究设计与方法

我们从加拿大 - 马耳他糖尿病研究中筛选了278名年龄在45至65岁之间的自由生活受试者。共有11名（年龄55±4岁，体重指数28±1.5kg/m²）符合纳入标准的受试者被招募：糖耐量受损、高密度脂蛋白胆固醇降低、血清甘油三酯升高以及中度高血压。经过8周的基线期后，他们被随机分配在两个为期3周的治疗期内食用富含KJM纤维的测试饼干（每100千卡饮食摄入量含0.5克葡甘露聚糖或8 - 13克/天）或麦麸纤维（WB）对照饼干，两个治疗期之间有2周的洗脱期。饮食能量相等、代谢受控且符合美国国家胆固醇教育计划第二步指南。血清脂质、血糖控制和血压为观察指标。

结果

与WB对照相比，在KJM治疗期间观察到血清胆固醇（总胆固醇，12.4±3.1%，P<0.004；低密度脂蛋白，22±3.9%，P<0.002；总胆固醇/高密度脂蛋白比值，15.2±3.4%，P<0.003；低密度脂蛋白/高密度脂蛋白比值，22.2±4.1%，P<0.002）、载脂蛋白（apo）B（15.1±4.3%，P<0.0004）、apo B/A - 1比值（13.1±3.4%，P<0.0003）和血清果糖胺（5.2±1.4%，P<0.002）降低。空腹血糖、胰岛素、甘油三酯、高密度脂蛋白胆固醇和体重保持不变。