Section of Endocrinology, Metabolism and Nutrition and the Metabolic Research Laboratory, Minneapolis VA Medical Center, Minneapolis, MN 55417, USA.
Metabolism. 2011 Sep;60(9):1300-11. doi: 10.1016/j.metabol.2011.01.016. Epub 2011 Mar 15.
We have developed a diet that over 5 weeks dramatically lowers plasma glucose in people with type 2 diabetes mellitus. This diet consists of 30% carbohydrate, 30% protein, and 40% fat and is referred to as a Low Biologically Available Glucose (LoBAG) diet. The diet also resulted in an approximately 30% increase in fasting insulin-like growth factor-I (IGF-I). Thus, we were interested in determining if the IGF-I elevation was due to an increase in ghrelin and growth hormone (GH) or to a change in IGF-I binding proteins (IGFBPs). Eight men with type 2 diabetes mellitus ingested a control diet (15% protein, 55% carbohydrate, and 30% fat) and a LoBAG(30) diet for 5 weeks in a randomized crossover design with a washout period in between. Before and after each 5-week period, subjects had blood drawn for total glycated hemoglobin and, at several time points over 24 hours, for GH, IGF-I, IGFBP-1, IGFBP-3, ghrelin, glucose, and insulin. Fasting and 24-hour glucose concentrations and total glycated hemoglobin were decreased, as expected (all Ps < .05). Fasting IGF-I increased by approximately 30% (P = .05) and remained unchanged throughout 24 hours. Ghrelin, GH, IGFBP-1, IGFBP-3, and insulin were not different between diets. Insulin and IGFBP-1 concentrations were reciprocal, as expected. Insulin-like growth factor-I binding protein 1 decreased as insulin increased to greater than approximately 30 to 40 μU/mL. Ingestion of a LoBAG(30) diet by weight-stable subjects with type 2 diabetes mellitus resulted in an increase in total IGF-I without an increase in ghrelin, GH, and IGFBP-3 or a change in IGFBP-1 regulation. The mechanism remains to be determined.
我们开发了一种饮食方案，该方案在 5 周内显著降低了 2 型糖尿病患者的血浆葡萄糖水平。这种饮食由 30%的碳水化合物、30%的蛋白质和 40%的脂肪组成，被称为低生物可利用葡萄糖（LoBAG）饮食。这种饮食还导致空腹胰岛素样生长因子-I（IGF-I）增加约 30%。因此，我们有兴趣确定 IGF-I 的升高是否是由于胃饥饿素和生长激素（GH）的增加，还是由于 IGF-I 结合蛋白（IGFBPs）的变化。8 名 2 型糖尿病男性患者以随机交叉设计的方式，在洗脱期之间，分别摄入对照饮食（15%的蛋白质、55%的碳水化合物和 30%的脂肪）和 LoBAG(30)饮食，各 5 周。在每个 5 周期间前后，采集血液以检测总糖化血红蛋白，并在 24 小时内的多个时间点，检测 GH、IGF-I、IGFBP-1、IGFBP-3、胃饥饿素、葡萄糖和胰岛素。空腹和 24 小时血糖浓度以及总糖化血红蛋白均降低，如预期的那样（均 P <.05）。空腹 IGF-I 增加约 30%（P =.05），并在 24 小时内保持不变。两种饮食之间，胃饥饿素、GH、IGFBP-1、IGFBP-3 和胰岛素没有差异。如预期的那样，胰岛素和 IGFBP-1 浓度呈负相关。当胰岛素增加到 30 到 40 μU/mL 以上时，IGFBP-1 浓度降低。2 型糖尿病体重稳定患者摄入 LoBAG(30)饮食后，总 IGF-I 增加，而胃饥饿素、GH 和 IGFBP-3 没有增加，IGFBP-1 的调节也没有变化。其机制仍有待确定。
