Yang Eun Ju, Kerver Jean M, Park Yi Kyung, Kayitsinga Jean, Allison David B, Song Won O
Food and Nutrition Database Research Center, Department of Food Science and Human Nutrition, Michigan State University, East Lansing 48824, USA.
Am J Clin Nutr. 2003 Jun;77(6):1426-33. doi: 10.1093/ajcn/77.6.1426.
Recommendations for preventing and treating type 2 diabetes include consuming carbohydrates, predominantly from whole grains, fruit, vegetables, and low-fat milk. However, the quantity and type of carbohydrates consumed may contribute to disorders of glycemic control.
We evaluated the association between carbohydrate intakes and biomarkers of glycemic control in a nationally representative sample of healthy US adults who participated in a cross-sectional study, the third National Health and Nutrition Examination Survey.
The sample (5730 men and 6125 women aged > or = 20 y) was divided into quintiles of carbohydrate intake (as a percentage of energy). Carbohydrate intakes were examined in relation to glycated hemoglobin (Hb A(1c)), plasma glucose, serum C-peptide, and serum insulin concentrations by using logistic regression.
Carbohydrate intakes were not associated with Hb A(1c), plasma glucose, or serum insulin concentrations in men or women after adjustment for confounding variables. Carbohydrate intakes were inversely associated with serum C-peptide concentrations in men and women. Odds ratios for elevated serum C-peptide concentrations for increasing quintiles of carbohydrate intake were 1.00, 0.88, 0.57, 0.39, and 0.75 (P for trend = 0.016) in men, and 1.00, 0.69, 0.57, 0.36, and 0.41 (P for trend = 0.007) in women. When carbohydrate intakes were further adjusted for intakes of total and added sugar, the association of serum C-peptide with carbohydrate intakes was strengthened in men.
Carbohydrate intakes were not associated with Hb A(1c), plasma glucose, or serum insulin concentrations but were inversely associated with the risk of elevated serum C-peptide; this supports current recommendations regarding carbohydrate intake in healthy adults.
预防和治疗2型糖尿病的建议包括摄入碳水化合物，主要来自全谷物、水果、蔬菜和低脂牛奶。然而，碳水化合物的摄入量和类型可能会导致血糖控制紊乱。
在参与横断面研究（第三次全国健康和营养检查调查）的具有全国代表性的美国健康成年人样本中，我们评估了碳水化合物摄入量与血糖控制生物标志物之间的关联。
样本（5730名男性和6125名年龄≥20岁的女性）被分为碳水化合物摄入量（占能量的百分比）的五分位数。通过逻辑回归分析碳水化合物摄入量与糖化血红蛋白（Hb A(1c)）、血浆葡萄糖、血清C肽和血清胰岛素浓度的关系。
在调整混杂变量后，男性和女性的碳水化合物摄入量与Hb A(1c)、血浆葡萄糖或血清胰岛素浓度均无关联。碳水化合物摄入量与男性和女性的血清C肽浓度呈负相关。男性碳水化合物摄入量增加的五分位数中血清C肽浓度升高的比值比分别为1.00、0.88、0.57、0.39和0.75（趋势P值=0.016），女性分别为1.00、0.69、0.57、0.36和0.41（趋势P值=0.007）。当碳水化合物摄入量进一步根据总糖和添加糖的摄入量进行调整时，男性血清C肽与碳水化合物摄入量之间的关联增强。
碳水化合物摄入量与Hb A(1c)、血浆葡萄糖或血清胰岛素浓度无关，但与血清C肽升高的风险呈负相关；这支持了目前关于健康成年人碳水化合物摄入量的建议。
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