膳食血糖指数和血糖负荷与日本肥胖成年人 HbA1c 的关系：酒卷控制肥胖计划的横断面分析。
Dietary glycemic index and glycemic load in relation to HbA1c in Japanese obese adults: a cross-sectional analysis of the Saku Control Obesity Program.
机构信息
Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.
出版信息
Nutr Metab (Lond). 2012 Sep 10;9(1):79. doi: 10.1186/1743-7075-9-79.
BACKGROUND
Dietary glycemic index or load is thought to play an important role in glucose metabolism. However, few studies have investigated the relation between glycemic index (GI) or load (GL) and glycemia in Asian populations. In this cross-sectional analysis of a randomized controlled trial, the Saku Control Obesity Program, we examined the relation between the baseline GI or GL and glycemia (HbA1c and fasting plasma glucose [FPG] levels), insulin resistance (HOMA-IR), β-cell function (HOMA-β), and other metabolic risk factors (lipid levels, diastolic and systolic blood pressure, and adiposity measures).
METHODS
The participants were 227 obese Japanese women and men. We used multiple linear regression models and logistic regression models to adjust for potential confounding factors such as age, sex, visceral fat area, total energy intake, and physical activity levels.
RESULTS
After adjustments for potential confounding factors, GI was not associated with HbA1c, but GL was positively associated with HbA1c. For increasing quartiles of GI, the adjusted mean HbA1c were 6.3%, 6.7%, 6.4%, and 6.4% (P for trend = 0.991). For increasing quartiles of GL, the adjusted mean HbA1c were 6.2%, 6.2%, 6.6%, and 6.5% (P for trend = 0.044). In addition, among participants with HbA1c ≥ 7.0%, 20 out of 28 (71%) had a high GL (≥ median); the adjusted odds ratio for HbA1c ≥ 7.0% among participants with higher GL was 3.1 (95% confidence interval [CI] = 1.2 to 8.1) compared to the participants with a lower GL (<median). Further, among 16 participants with FPG ≥ 150 mg/dL, 13 participants (81.3%) had a higher GL; the adjusted odds ratio for FPG ≥ 150 mg/dL among participants with a higher GL was 8.5 (95% confidence interval = 1.7 to 43.4) compared to those with a lower GL. In contrast, GI and GL were not associated with metabolic risk factors other than glycemia.
CONCLUSIONS
Our findings suggest that participants with poor glycemic control tend to have a higher GL in an obese Japanese population.
背景
人们认为膳食血糖指数或负荷在葡萄糖代谢中起着重要作用。然而，很少有研究调查血糖指数（GI）或负荷（GL）与亚洲人群血糖之间的关系。在这项随机对照试验的横断面分析中，即 Saku 控制肥胖计划，我们研究了基线 GI 或 GL 与血糖（HbA1c 和空腹血浆葡萄糖 [FPG] 水平）、胰岛素抵抗（HOMA-IR）、β细胞功能（HOMA-β）和其他代谢风险因素（血脂水平、舒张压和收缩压以及肥胖测量）之间的关系。
方法
参与者为 227 名肥胖的日本女性和男性。我们使用多元线性回归模型和逻辑回归模型来调整年龄、性别、内脏脂肪面积、总能量摄入和体力活动水平等潜在混杂因素。
结果
在调整了潜在混杂因素后，GI 与 HbA1c 无关，但 GL 与 HbA1c 呈正相关。对于 GI 的递增四分位区间，调整后的平均 HbA1c 分别为 6.3%、6.7%、6.4%和 6.4%（趋势 P 值=0.991）。对于 GL 的递增四分位区间，调整后的平均 HbA1c 分别为 6.2%、6.2%、6.6%和 6.5%（趋势 P 值=0.044）。此外，在 HbA1c≥7.0%的参与者中，28 人中的 20 人（71%）GL 较高（≥中位数）；与 GL 较低（<中位数）的参与者相比，GL 较高的参与者 HbA1c≥7.0%的调整比值比为 3.1（95%置信区间 [CI]：1.2 至 8.1）。此外，在 16 名 FPG≥150 mg/dL 的参与者中，13 名参与者（81.3%）GL 较高；与 GL 较低的参与者相比，GL 较高的参与者 FPG≥150 mg/dL 的调整比值比为 8.5（95%置信区间：1.7 至 43.4）。相比之下，GI 和 GL 与血糖以外的其他代谢风险因素无关。
结论
我们的研究结果表明，在肥胖的日本人群中，血糖控制较差的参与者 GL 往往较高。
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