Mahalle N, Kulkarni M V, Naik S S, Garg M K
Deenanath Mangeshkar Hospital and Research Center, Biochemistry Section, Department of Pathology, Erandawane, Pune-411004, India; Department of Endocrinology, Command Hospital (Southern Command), Pune.
Division of Biochemistry, Department of Chemistry, University of Pune.
J Diabetes Complications. 2014 Jul-Aug;28(4):536-41. doi: 10.1016/j.jdiacomp.2012.09.008. Epub 2014 Apr 16.
Insulin resistance (IR) and inflammation have been implicated in pathogenesis of diabetes and cardiovascular disease. Dietary factors have been reported to be associated to insulin resistance and inflammation. Hence, we studied the association of dietary factors with IR and inflammation in known patients with diabetes mellitus and coronary artery disease with the hypothesis that carbohydrate and fat will be positively; and protein, fiber and mineral will be negatively associated with IR and inflammatory markers.
Three hundred patients (M: 216; F: 84, age: 25-92) who had coronary disease on angiography were included in this study consecutively. All patients were evaluated for anthropometry and cardiovascular risk factors, and blood samples were collected for biochemical and inflammatory markers. Nutrition assessment was done once at the time of recruitment, based on 24h dietary recall.
Diabetic patients had significantly lower protein and total dietary fiber intake as compared to non diabetics. Diabetic patients had lower intake of vitamin A, riboflavin and vitamin B12. There was significantly lower intake of minerals by diabetic patients. Dietary carbohydrate and fat were positively, and protein and dietary fiber intakes were negatively correlated with HOMA-IR and IL-6. There was no correlation of individual amino acids with HOMA-IR but showed strong negative correlation with inflammatory markers (hsCRP; IL-6 and TNF-α). Intake of vitamins and minerals was negatively correlated with HOMA-IR and inflammatory markers. There is a strong correlation between dietary factors, insulin resistance and inflammatory markers.
胰岛素抵抗（IR）和炎症与糖尿病及心血管疾病的发病机制有关。据报道，饮食因素与胰岛素抵抗和炎症相关。因此，我们研究了饮食因素与已知糖尿病和冠状动脉疾病患者的IR及炎症之间的关联，假设碳水化合物和脂肪呈正相关；而蛋白质、纤维和矿物质与IR及炎症标志物呈负相关。
本研究连续纳入了300例经血管造影确诊为冠心病的患者（男性216例，女性84例，年龄25 - 92岁）。对所有患者进行人体测量和心血管危险因素评估，并采集血样检测生化和炎症标志物。在招募时基于24小时饮食回忆进行一次营养评估。
与非糖尿病患者相比，糖尿病患者的蛋白质和总膳食纤维摄入量显著较低。糖尿病患者的维生素A、核黄素和维生素B12摄入量较低。糖尿病患者的矿物质摄入量也显著较低。饮食中的碳水化合物和脂肪与稳态模型评估的胰岛素抵抗（HOMA-IR）及白细胞介素-6（IL-6）呈正相关，而蛋白质和膳食纤维摄入量与HOMA-IR及IL-6呈负相关。单个氨基酸与HOMA-IR无相关性，但与炎症标志物（高敏C反应蛋白；IL-6和肿瘤坏死因子-α）呈强负相关。维生素和矿物质的摄入量与HOMA-IR及炎症标志物呈负相关。饮食因素、胰岛素抵抗和炎症标志物之间存在很强的相关性。
