Borkman M, Campbell L V, Chisholm D J, Storlien L H
Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, New South Wales, Australia.
J Clin Endocrinol Metab. 1991 Feb;72(2):432-7. doi: 10.1210/jcem-72-2-432.
To examine whether achievable dietary changes influence insulin sensitivity, we performed euglycemic hyperinsulinemic glucose clamps in eight normal subjects who were prescribed high carbohydrate and high fat diets. The high carbohydrate diet was more than 50% (of energy intake) carbohydrate and less than 30% fat; the high fat diet was more than 45% fat (predominantly saturated) and less than 40% carbohydrate. The diets were consumed over consecutive 3-week periods in random sequence. The mean whole body glucose uptake during the glucose clamps was similar after the high carbohydrate (48.3 mumol/kg.min) and high fat diets (47.0 mumol/kg.min; P = 0.5; 95% confidence interval for the difference, -3.4 to 5.9 mumol/kg.min). Fasting blood glucose and serum insulin concentrations were also unchanged. In contrast, there were substantial effects on lipoprotein metabolism. During the high carbohydrate diet, fasting serum cholesterol decreased by 17% (P = 0.06), low density lipoprotein cholesterol decreased by 20% (P = 0.05), high density lipoprotein cholesterol decreased by 24% (P less than 0.005), and triglyceride increased by 33% (P = 0.06) compared with levels during the high fat diet. These results suggest that practically achievable high carbohydrate diets do not enhance insulin sensitivity in nondiabetic subjects and have net effects on lipoprotein metabolism that may be unfavorable.
为了研究可实现的饮食变化是否会影响胰岛素敏感性，我们对8名正常受试者进行了正常血糖高胰岛素葡萄糖钳夹试验，这些受试者被规定摄入高碳水化合物和高脂肪饮食。高碳水化合物饮食中碳水化合物占能量摄入的比例超过50%，脂肪占比低于30%；高脂肪饮食中脂肪占比超过45%（主要是饱和脂肪），碳水化合物占比低于40%。这些饮食以随机顺序连续食用3周。在高碳水化合物饮食（48.3微摩尔/千克·分钟）和高脂肪饮食（47.0微摩尔/千克·分钟；P = 0.5；差异的95%置信区间为-3.4至5.9微摩尔/千克·分钟）后，葡萄糖钳夹期间的平均全身葡萄糖摄取量相似。空腹血糖和血清胰岛素浓度也没有变化。相比之下，对脂蛋白代谢有显著影响。与高脂肪饮食期间的水平相比，在高碳水化合物饮食期间，空腹血清胆固醇下降了17%（P = 0.06），低密度脂蛋白胆固醇下降了20%（P = 0.05），高密度脂蛋白胆固醇下降了24%（P < 0.005），甘油三酯增加了33%（P = 0.06）。这些结果表明，实际可实现的高碳水化合物饮食不会增强非糖尿病受试者的胰岛素敏感性，并且对脂蛋白代谢有净影响，可能是不利的。
