Bantle J P, Swanson J E, Thomas W, Laine D C
Department of Medicine, School of Public Health, University of Minnesota, Minneapolis 55455.
Diabetes Care. 1992 Nov;15(11):1468-76. doi: 10.2337/diacare.15.11.1468.
To assess the metabolic effects of chronic dietary fructose consumption in diabetic subjects.
Six type I and 12 type II diabetic subjects consumed, in random order, two isocaloric study diets for 28 days. In one diet, 20% of energy was derived from fructose. In the other diet, < 3% of energy came from fructose, and carbohydrate energy was derived primarily from starch. Both study diets were composed of common foods. All meals were prepared in a metabolic kitchen where all foods were weighed during meal preparation.
Mean plasma glucose, urine glucose, and serum glycosylated albumin values were lower during the fructose diet than during the starch diet, but the differences achieved only marginal statistical significance. The day-28 value for mean plasma glucose was 12.5% lower (P = 0.03) during the fructose diet than during the starch diet. At days 14, 21, and 28, fasting serum cholesterol and LDL cholesterol were both significantly higher during the fructose diet than during the starch diet. The day-28 values for serum cholesterol and LDL cholesterol during the fructose diet were 6.9% (P = 0.008) and 10.9% (P = 0.002) higher, respectively, than the corresponding values during the starch diet. No differences were observed between the study diets in fasting serum HDL cholesterol, fasting serum triglycerides, peak postprandial serum triglycerides, or fasting serum lactate. Peak postprandial serum lactate was significantly higher during the fructose diet. Type I and type II diabetic subjects responded to the diets in a consistent way, but type I subjects experienced significantly more hypoglycemia during the fructose diet than during the starch diet.
A high-fructose diet may result in reduced glycemia in diabetic subjects but at the expense of increased fasting serum total and LDL cholesterol.
评估糖尿病患者长期饮食摄入果糖的代谢影响。
6名1型糖尿病患者和12名2型糖尿病患者随机先后食用两种等热量的研究饮食，为期28天。一种饮食中，20%的能量来自果糖。另一种饮食中，果糖提供的能量<3%，碳水化合物能量主要来自淀粉。两种研究饮食均由常见食物组成。所有餐食均在代谢厨房制备，餐食制备过程中所有食物均称重。
果糖饮食期间的平均血浆葡萄糖、尿糖和血清糖化白蛋白值低于淀粉饮食期间，但差异仅达到边缘统计学显著性。果糖饮食期间第28天的平均血浆葡萄糖值比淀粉饮食期间低12.5%（P = 0.03）。在第14、21和28天，果糖饮食期间的空腹血清胆固醇和低密度脂蛋白胆固醇均显著高于淀粉饮食期间。果糖饮食期间第28天的血清胆固醇和低密度脂蛋白胆固醇值分别比淀粉饮食期间的相应值高6.9%（P = 0.008）和10.9%（P = 0.002）。两种研究饮食在空腹血清高密度脂蛋白胆固醇、空腹血清甘油三酯、餐后血清甘油三酯峰值或空腹血清乳酸方面未观察到差异。果糖饮食期间餐后血清乳酸峰值显著更高。1型和2型糖尿病患者对饮食的反应一致，但1型患者在果糖饮食期间经历的低血糖比淀粉饮食期间显著更多。
高果糖饮食可能导致糖尿病患者血糖降低，但代价是空腹血清总胆固醇和低密度脂蛋白胆固醇升高。
