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等热量低血糖生成指数饮食可改善多囊卵巢综合征妇女的胰岛素敏感性。

An isocaloric low glycemic index diet improves insulin sensitivity in women with polycystic ovary syndrome.

出版信息

J Acad Nutr Diet. 2013 Nov;113(11):1523-1531. doi: 10.1016/j.jand.2013.06.347. Epub 2013 Aug 30.

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 5% to 10% of women worldwide. Approximately half of women with PCOS are lean, yet may still present with central obesity and metabolic disturbances. Low-glycemic index (GI) dietary intervention studies have demonstrated improvements in insulin sensitivity in insulin-resistant populations; however, there is little evidence of this effect in women with PCOS. This research aimed to determine the efficacy of an isocaloric low-GI dietary intervention on insulin sensitivity, independent of weight change, in women with PCOS. A nonrandomized 12-week low-GI dietary intervention, preceded by a 12-week habitual diet control phase and proceeded by a 12-week follow-up phase was conducted. Dietary intake, body composition, and metabolic risk markers were determined at baseline, after completion of the habitual diet control phase, and after the low-GI dietary intervention. Twenty-six participants were recruited at baseline, 22 commenced and 21 participants completed the low-GI dietary intervention phase. The primary outcome was change in insulin sensitivity. Secondary outcomes included assessment of changes to lipids, body composition, and estimated macronutrient intake. Repeated measures analysis of variance with Bonferroni correction were used to detect changes to outcomes across study timepoints. Twenty-one women with PCOS with mean (± standard deviation) age of 32.1±6.7 years completed the 12-week low-GI dietary intervention. As expected, no significant changes occurred during the 12-week habitual diet control phase. However, during the dietary intervention phase, dietary GI decreased from 54.5±3.5 to 48.6±5.1 (P<0.001) with a concurrent small reduction in saturated fat intake (12.4%±3% to 11.7%±3% contribution from energy, P=0.03), despite no specific recommendations to modify fat intake. Measures of insulin sensitivity and nonesterified fatty acid improved after intervention (P=0.03 and P=0.01, respectively). This is the first study to implement an isocaloric low-GI diet in women with PCOS and findings may contribute to the limited research in this area.

摘要

多囊卵巢综合征(PCOS)是一种常见的内分泌疾病,影响全球 5%至 10%的女性。大约一半患有 PCOS 的女性体型偏瘦,但仍可能存在中心性肥胖和代谢紊乱。低升糖指数(GI)饮食干预研究表明,在胰岛素抵抗人群中,这种饮食干预可改善胰岛素敏感性;然而,在患有 PCOS 的女性中,这种效果的证据很少。本研究旨在确定等热量低 GI 饮食干预在不改变体重的情况下对 PCOS 女性胰岛素敏感性的疗效。进行了一项非随机的 12 周低 GI 饮食干预,之前是 12 周的习惯性饮食控制阶段,之后是 12 周的随访阶段。在基线、完成习惯性饮食控制阶段后和低 GI 饮食干预后,测定饮食摄入、身体成分和代谢风险标志物。26 名参与者在基线时被招募,22 名参与者开始并完成了低 GI 饮食干预阶段。主要结局是胰岛素敏感性的变化。次要结局包括评估脂质、身体成分和估计宏量营养素摄入量的变化。使用重复测量方差分析和 Bonferroni 校正来检测研究时间点的结果变化。21 名患有 PCOS 的女性完成了 12 周的低 GI 饮食干预,平均(±标准差)年龄为 32.1±6.7 岁。正如预期的那样,在 12 周的习惯性饮食控制阶段没有发生显著变化。然而,在饮食干预阶段,饮食 GI 从 54.5±3.5 降至 48.6±5.1(P<0.001),同时饱和脂肪摄入量略有减少(从能量的 12.4%±3%降至 11.7%±3%,P=0.03),尽管没有特别建议改变脂肪摄入量。干预后胰岛素敏感性和非酯化脂肪酸的测量值改善(P=0.03 和 P=0.01)。这是第一项在 PCOS 女性中实施等热量低 GI 饮食的研究,研究结果可能有助于该领域有限的研究。

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