高蛋白早餐会使2型糖尿病患者对随后的午餐产生更大的胰岛素及葡萄糖依赖性促胰岛素多肽反应。
A high-protein breakfast induces greater insulin and glucose-dependent insulinotropic peptide responses to a subsequent lunch meal in individuals with type 2 diabetes.
作者信息
Park Young-Min, Heden Timothy D, Liu Ying, Nyhoff Lauryn M, Thyfault John P, Leidy Heather J, Kanaley Jill A
机构信息
Departments of Nutrition and Exercise Physiology and.
Departments of Nutrition and Exercise Physiology and Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO.
出版信息
J Nutr. 2015 Mar;145(3):452-8. doi: 10.3945/jn.114.202549. Epub 2014 Dec 24.
BACKGROUND
The previous meal modulates the postprandial glycemic responses to a subsequent meal; this is termed the second-meal phenomenon.
OBJECTIVE
This study examined the effects of high-protein vs. high-carbohydrate breakfast meals on the metabolic and incretin responses after the breakfast and lunch meals.
METHODS
Twelve type 2 diabetic men and women [age: 21-55 y; body mass index (BMI): 30-40 kg/m(2)] completed two 7-d breakfast conditions consisting of 500-kcal breakfast meals as protein (35% protein/45% carbohydrate) or carbohydrate (15% protein/65% carbohydrate). On day 7, subjects completed an 8-h testing day. After an overnight fast, the subjects consumed their respective breakfast followed by a standard 500-kcal high-carbohydrate lunch meal 4 h later. Blood samples were taken throughout the day for assessment of 4-h postbreakfast and 4-h postlunch total area under the curve (AUC) for glucose, insulin, C-peptide, glucagon, glucose-dependent insulinotropic peptide (GIP), and glucagon-like peptide 1 (GLP-1).
RESULTS
Postbreakfast glucose and GIP AUCs were lower after the protein (17%) vs. after the carbohydrate (23%) condition (P < 0.05), whereas postbreakfast insulin, C-peptide, glucagon, and GLP-1 AUCs were not different between conditions. A protein-rich breakfast may reduce the consequences of hyperglycemia in this population. Postlunch insulin, C-peptide, and GIP AUCs were greater after the protein condition vs. after the carbohydrate condition (second-meal phenomenon; all, P < 0.05), but postlunch AUCs were not different between conditions. The overall glucose, glucagon, and GLP-1 responses (e.g., 8 h) were greater after the protein condition vs. after the carbohydrate condition (all, P < 0.05).
CONCLUSIONS
In type 2 diabetic individuals, compared with a high-carbohydrate breakfast, the consumption of a high-protein breakfast meal attenuates the postprandial glucose response and does not magnify the response to the second meal. Insulin, C-peptide, and GIP concentrations demonstrate the second-meal phenomenon and most likely aid in keeping the glucose concentrations controlled in response to the subsequent meal. The trial was registered at www.clinicaltrials.gov/ct2/show/NCT02180646 as NCT02180646.
背景
前一餐会调节对随后一餐的餐后血糖反应；这被称为第二餐现象。
目的
本研究探讨高蛋白早餐与高碳水化合物早餐对早餐和午餐后代谢及肠促胰岛素反应的影响。
方法
12名2型糖尿病男性和女性[年龄：21 - 55岁；体重指数（BMI）：30 - 40 kg/m²]完成了两种为期7天的早餐饮食方案，早餐能量均为500千卡，分别为蛋白质餐（35%蛋白质/45%碳水化合物）或碳水化合物餐（15%蛋白质/65%碳水化合物）。在第7天，受试者完成一个8小时的测试日。经过一夜禁食后，受试者食用各自的早餐，4小时后再食用一份标准的500千卡高碳水化合物午餐。全天采集血样，以评估早餐后4小时和午餐后4小时葡萄糖、胰岛素、C肽、胰高血糖素、葡萄糖依赖性促胰岛素多肽（GIP）和胰高血糖素样肽1（GLP - 1）的曲线下总面积（AUC）。
结果
与碳水化合物餐（23%）相比，蛋白质餐（17%）后早餐后的葡萄糖和GIP的AUC较低（P < 0.05），而早餐后胰岛素、C肽、胰高血糖素和GLP - 1的AUC在两种饮食方案之间无差异。富含蛋白质的早餐可能会减轻该人群高血糖的后果。与碳水化合物餐相比，蛋白质餐午餐后胰岛素、C肽和GIP的AUC更高（第二餐现象；均P < 0.05），但午餐后AUC在两种饮食方案之间无差异。蛋白质餐条件下总体葡萄糖、胰高血糖素和GLP - 1反应（如8小时）比碳水化合物餐条件下更大（均P < 0.05）。
结论
在2型糖尿病个体中，与高碳水化合物早餐相比，食用高蛋白早餐可减弱餐后血糖反应，且不会放大对第二餐的反应。胰岛素、C肽和GIP浓度表现出第二餐现象，很可能有助于控制对随后一餐的血糖浓度。该试验在www.clinicaltrials.gov/ct2/show/NCT02180646注册，注册号为NCT02180646。
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