Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan.
Tohoku J Exp Med. 2013;231(1):63-74. doi: 10.1620/tjem.231.63.
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are ω3-polyunsaturated fatty acids mainly contained in the blue-backed fish oil, and are effective in decreasing the lipids disorder and the cardiovascular incidence among diabetic patients. Moreover, it has been suggested that EPA and DHA may improve the insulin resistance and glucose metabolism. However, the clinical effects of EPA and DHA on glucose metabolism remain unclear. We aimed to clarify the effects of EPA/DHA treatment on glycemic control in type 2 diabetes mellitus. This study was a multicenter prospective randomized controlled trial involving 30 elderly type 2 diabetic patients on a liquid diet. Their exercises were almost zero and the content of their meals was strictly managed and understood well. Therefore, the difference by the individual's life was a minimum. The subjects were divided into two groups: those receiving EPA/DHA-rich liquid diet [EPA/DHA (+)] or liquid diet lacking EPA/DHA [EPA/DHA (-)]. Changes in factors related to glucose and lipid metabolism were assessed after the three-month study. Serum concentrations of EPA rose in EPA/DHA (+), although the levels of DHA and fasting C-peptide remained unchanged in EPA/DHA (+). In addition, there was a significant decline in the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), fasting remnant-like particles and apolipoprotein (apo) B in EPA/DHA (+), compared with the values in EPA/DHA (-). EPA/DHA-rich diet might improve glucose metabolism in elderly type 2 diabetic patients on a liquid diet. This phenomenon may be due to the improved insulin resistance mediated by the rise in serum EPA concentrations.
二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）是ω3 多不饱和脂肪酸，主要存在于蓝背鱼类的鱼油中，可有效降低糖尿病患者的脂质紊乱和心血管发病率。此外，有研究表明 EPA 和 DHA 可能改善胰岛素抵抗和葡萄糖代谢。然而，EPA 和 DHA 对葡萄糖代谢的临床疗效仍不清楚。我们旨在阐明 EPA/DHA 治疗对 2 型糖尿病患者血糖控制的影响。这是一项多中心前瞻性随机对照试验，纳入了 30 名接受液体饮食的老年 2 型糖尿病患者。他们的运动量几乎为零，并且严格管理和充分了解他们的膳食内容。因此，个体生活方式的差异最小。受试者分为两组：接受富含 EPA/DHA 的液体饮食组（EPA/DHA (+)）或缺乏 EPA/DHA 的液体饮食组（EPA/DHA (-)）。在为期 3 个月的研究后，评估与血糖和脂质代谢相关的因素的变化。尽管 EPA/DHA (+) 组的 DHA 和空腹 C 肽水平保持不变，但 EPA/DHA (+) 组的血清 EPA 浓度升高。此外，与 EPA/DHA (-) 组相比，EPA/DHA (+) 组的空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹残粒样颗粒和载脂蛋白（apo）B 显著下降。富含 EPA/DHA 的饮食可能改善接受液体饮食的老年 2 型糖尿病患者的葡萄糖代谢。这种现象可能是由于血清 EPA 浓度升高介导的胰岛素抵抗改善所致。
