Ybarra J, James R W, Makoundou V, Bioletto S, Golay A
Departamento de obstetricia y gynecologia, Instituto Universitario Dexeus, Universidad autonoma de Barcelona, Barcelona, Spain.
Diabetes Metab. 2001 Dec;27(6):701-8.
We assessed the efficacy of a modest weight loss (1.5 +/- 0.3 kg) and simultaneous rapid improvement in glycemic control on fasting an post-prandial lipoprotein sub-fractions in nine overweight (BMI=28 +/- 1.7 kg/m(2)) well controlled Type 2 diabetic patients (HbA(1c)=7.3 +/- 0.1%).
They followed a non-drastical hypocaloric balanced diet (1 561 +/- 39 kcal/day) over ten days in hospital. The fat content of the diet was significantly lowered from 96 +/- 12 g/day to 62 +/- 4 g/day (p<0.03). Plasma lipid and lipoprotein levels were measured in fasting and four hours after standard breakfast and four hours after standard lunch twice before and after ten days of hospitalization. The sub-fractions of very low density and low density lipoprotein were obtained by cumulative flotation ultracentrifugation.
This weight loss reduced two well known independent cardiovascular risk factors such as the post-prandial glycemic excursions (p<0.05) and the post-prandial lipemia (p<0.05). Multiple linear regression analyses identified weight loss as an independent variable accounting for the ability to predict post-prandial capillary triglyceride clearance (p<0.05). Improvements in post-prandial glycemic excursions which was also entered as a parameter did not appear as a variable being able to predict these changes (p=0.4). In addition to the 23% improvement in post-prandial capillary triglyceride clearance (p<0.02), a decrement in post-prandial VLDL-2 triglyceride enrichment was found (p<0.05). Finally, fasting and post-prandial LDL-3 cholesterol levels were diminished (p<0.05) and the LDL-2/LDL-3 mass ratio post-prandial kinetics were improved (p<0.05).
Even a modest weight loss in overweight, average controlled type 2 diabetic patients can achieve a significant improvement in two cardiovascular risk factors, namely post-prandial triglyceride excursions and the LDL-2/LDL-3 mass ratio kinetics independently from glycemic control improvements.
我们评估了适度体重减轻（1.5±0.3千克）以及同时快速改善血糖控制对9名超重（体重指数=28±1.7千克/平方米）且病情控制良好的2型糖尿病患者（糖化血红蛋白=7.3±0.1%）空腹及餐后脂蛋白亚组分的影响。
他们在医院内遵循非极端低热量均衡饮食（1561±39千卡/天），为期十天。饮食中的脂肪含量从96±12克/天显著降至62±4克/天（p<0.03）。在住院十天前后，分别两次测量空腹、标准早餐后四小时以及标准午餐后四小时的血浆脂质和脂蛋白水平。通过累积漂浮超速离心法获得极低密度脂蛋白和低密度脂蛋白的亚组分。
这种体重减轻降低了两个众所周知的独立心血管危险因素，即餐后血糖波动（p<0.05）和餐后血脂异常（p<0.05）。多元线性回归分析确定体重减轻是一个独立变量，可用于预测餐后毛细血管甘油三酯清除能力（p<0.05）。作为参数输入的餐后血糖波动的改善并未表现为能够预测这些变化的变量（p=0.4）。除了餐后毛细血管甘油三酯清除率提高23%（p<0.02）外，还发现餐后极低密度脂蛋白-2甘油三酯富集减少（p<0.05）。最后，空腹和餐后低密度脂蛋白-3胆固醇水平降低（p<0.05），餐后低密度脂蛋白-2/低密度脂蛋白-3质量比动力学得到改善（p<0.05）。
即使是超重、病情控制一般的2型糖尿病患者适度减轻体重，也能在不依赖血糖控制改善的情况下，显著改善两个心血管危险因素，即餐后甘油三酯波动和低密度脂蛋白-2/低密度脂蛋白-3质量比动力学。
Zotero 插件