Laville M, Nazare J-A
Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ de lyon, Lyon, France.
Obes Rev. 2009 Mar;10 Suppl 1:24-33. doi: 10.1111/j.1467-789X.2008.00562.x.
Insulin resistance is associated with type 2 diabetes, hypertension and cardiovascular disease and the dietary factors involved in these metabolic disorders are still misunderstood. In animal studies, sugars, particularly sucrose and fructose, have been shown to decrease insulin sensitivity, with potential association with an induced hypertriglyceridemia. But in humans, the effects of sugars on insulin sensitivity are still debated. The present work first gives an overview of the metabolic pathways that could be implicated in the development of insulin resistance by sugars. Then, a review of the studies (intervention, prospective and cross-sectional) on the relationship between sugars, insulin resistance and diabetes is made in order to determine the level of proof concerning the association of sugars consumption and diabetes. All these studies failed to demonstrate an obvious relationship between the intake of total simple carbohydrates and glycaemic control or risk to develop a type 2 diabetes and particularly specific evidence is missing in terms of sucrose effect on diabetes. Concerning fructose, there are still discrepancies between studies' conclusions about the long-term deleterious effect on diabetes development. But its effect on lipogenesis and triglyceridemia has to be taken into account, considering the growing use of fructose in food industry and sugar-sweetened drinks.
胰岛素抵抗与2型糖尿病、高血压和心血管疾病相关，而涉及这些代谢紊乱的饮食因素仍未被充分理解。在动物研究中，糖类，尤其是蔗糖和果糖，已被证明会降低胰岛素敏感性，并可能与诱发的高甘油三酯血症有关。但在人类中，糖类对胰岛素敏感性的影响仍存在争议。本研究首先概述了糖类可能参与胰岛素抵抗发生发展的代谢途径。然后，对关于糖类、胰岛素抵抗和糖尿病之间关系的研究（干预性、前瞻性和横断面研究）进行综述，以确定糖类摄入与糖尿病关联的证据水平。所有这些研究均未能证明总简单碳水化合物的摄入量与血糖控制或患2型糖尿病风险之间存在明显关系，尤其是在蔗糖对糖尿病的影响方面缺乏具体证据。关于果糖，研究结论在其对糖尿病发展的长期有害影响方面仍存在差异。但考虑到果糖在食品工业和含糖饮料中的使用日益增加，必须考虑其对脂肪生成和甘油三酯血症的影响。
