Bozzetto Lutgarda, Annuzzi Giovanni, Pacini Giovanni, Costabile Giuseppina, Vetrani Claudia, Vitale Marilena, Griffo Ettore, Giacco Angela, De Natale Claudia, Cocozza Sara, Della Pepa Giuseppe, Tura Andrea, Riccardi Gabriele, Rivellese Angela A
Department of Clinical Medicine and Surgery, Federico II University, Via Pansini, 5, 80131, Naples, Italy.
Diabetologia. 2015 Jul;58(7):1551-60. doi: 10.1007/s00125-015-3592-x. Epub 2015 Apr 24.
AIM/HYPOTHESIS: Dietary polyphenols and long chain n-3 polyunsaturated fatty acids (LCn3) are associated with lower cardiovascular risk. This may relate to their influence on glucose metabolism and diabetes risk. We evaluated the effects of diets naturally rich in polyphenols and/or LCn3 of marine origin on glucose metabolism in people at high cardiometabolic risk.
According to a 2 × 2 factorial design, individuals with high waist circumference and at least one more component of the metabolic syndrome were recruited at the obesity outpatient clinic. Eighty-six participants were randomly assigned by MINIM software to an isoenergetic diet: (1) control, low in LCn3 and polyphenol (analysed n = 20); (2) rich in LCn3 (n = 19); (3) rich in polyphenols (n = 19); or (4) rich in LCn3 and polyphenols (n = 19). The assigned diets were known for the participants and blinded for people doing measurements. Before and after the 8 week intervention, participants underwent a 3 h OGTT and a test meal with a similar composition as the assigned diet for the evaluation of plasma glucose, insulin and glucagon-like peptide 1 (GLP-1) concentrations, and indices of insulin sensitivity and beta cell function.
During OGTT, polyphenols significantly reduced plasma glucose total AUC (p = 0.038) and increased early insulin secretion (p = 0.048), while LCn3 significantly reduced beta cell function (p = 0.031) (two-factor ANOVA). Moreover, polyphenols improved post-challenge oral glucose insulin sensitivity (OGIS; p = 0.05 vs control diet by post hoc ANOVA). At test meal, LCn3 significantly reduced GLP-1 total postprandial AUC (p < 0.001; two-factor ANOVA).
CONCLUSION/INTERPRETATION: Diets naturally rich in polyphenols reduce blood glucose response, likely by increasing early insulin secretion and insulin sensitivity. These effects may favourably influence diabetes and cardiovascular risk. The implications of the decrease in insulin secretion and postprandial GLP-1 observed with diets rich in marine LCn3 need further clarification.
ClinicalTrials.gov NCT01154478.
The trial was funded by European Community's Seventh Framework Programme FP7/2009-2012 under grant agreement FP7-KBBE-222639, Etherpaths Project and 'Ministero Istruzione Università e Ricerca' PRIN 2010-2011 - 2010JCWWKM.
目的/假设：膳食多酚和长链n-3多不饱和脂肪酸（LCn3）与较低的心血管疾病风险相关。这可能与其对葡萄糖代谢和糖尿病风险的影响有关。我们评估了天然富含多酚和/或海洋来源LCn3的饮食对心血管代谢风险较高人群葡萄糖代谢的影响。
根据2×2析因设计，在肥胖门诊招募腰围较大且至少有一项代谢综合征其他组分的个体。86名参与者通过MINIM软件随机分配至等能量饮食组：（1）对照组，LCn3和多酚含量低（分析样本量n = 20）；（2）富含LCn3组（n = 19）；（3）富含多酚组（n = 19）；或（4）富含LCn3和多酚组（n = 19）。参与者知晓所分配的饮食，而进行测量的人员对此不知情。在8周干预前后，参与者接受3小时口服葡萄糖耐量试验（OGTT）以及与所分配饮食成分相似的测试餐，以评估血浆葡萄糖、胰岛素和胰高血糖素样肽1（GLP-1）浓度，以及胰岛素敏感性和β细胞功能指标。
在OGTT期间，多酚显著降低了血浆葡萄糖的总曲线下面积（AUC）（p = 0.038）并增加了早期胰岛素分泌（p = 0.048），而LCn3显著降低了β细胞功能（p = 0.031）（双因素方差分析）。此外，多酚改善了口服葡萄糖激发后的胰岛素敏感性（OGIS；事后检验方差分析，与对照饮食相比p = 0.05）。在测试餐时，LCn3显著降低了餐后GLP-1的总AUC（p < 0.001；双因素方差分析）。
结论/解读：天然富含多酚的饮食可降低血糖反应，可能是通过增加早期胰岛素分泌和胰岛素敏感性实现的。这些作用可能对糖尿病和心血管疾病风险产生有利影响。富含海洋来源LCn3的饮食导致胰岛素分泌和餐后GLP-1降低的影响需要进一步阐明。
ClinicalTrials.gov NCT01154478。
该试验由欧洲共同体第七框架计划FP7/2009 - 2012资助，资助协议编号为FP7 - KBBE - 222639，Etherpaths项目以及“意大利教育、大学和科研部”2010 - 2011年PRIN - 2010JCWWKM。
