Zhang Shixiu, Ma Yiyi, Guo Hongwei, Wan Wentao, Xue Kun
Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China.
Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China.
Asia Pac J Clin Nutr. 2015;24(3):546-54. doi: 10.6133/apjcn.2015.24.3.17.
The objective of this study was to test how the genetic polymorphisms located within the lipoprotein lipase (LPL) locus would modulate the relationship between a diet high in carbohydrate and insulin resistance related traits in metabolic syndrome adults. A one year nutritional intervention study focusing on education to increase dietary intake of whole grain, vegetable and fruit, and to reduce the intake of sodium, simple sugar and dietary fat (especially cooking oil and pork lard) was conducted. Two districts in Shanghai, China were randomly selected to be the intervention and control group, and patients (n=235) with metabolic syndrome within these two districts were selected based on a multistage sampling method. Fasting glucose was reduced in rs328 CC homozygotes (p=0.028) but not G carriers (p=0.686) within the intervention group. Also an ancillary study with greater statistical power by combining the baseline measurements across both the intervention and control groups was conducted to test the cross-sectional statistical interactions between carbohydrate/fat and lipoprotein lipase genotypes for homeostasis model assessment of insulin resistance/insulin/fasting glucose. Increased carbohydrate intakes were positively associated with homeostasis model assessment of insulin resistance and insulin in rs328 G carriers but not CC homozygotes (p for interaction was 0.025). These results indicate that diet high in carbohydrate may not be suitable for metabolic syndrome rs328 G carriers, calling for the development of personalized dietary intervention for metabolic syndrome subjects.
本研究的目的是测试脂蛋白脂肪酶（LPL）基因座内的基因多态性如何调节代谢综合征成年人中高碳水化合物饮食与胰岛素抵抗相关性状之间的关系。开展了一项为期一年的营养干预研究，重点是进行教育，以增加全谷物、蔬菜和水果的饮食摄入量，并减少钠、单糖和膳食脂肪（特别是食用油和猪油）的摄入量。在中国上海随机选择两个区作为干预组和对照组，并基于多阶段抽样方法在这两个区内选择了代谢综合征患者（n = 235）。干预组中，rs328 CC纯合子的空腹血糖降低（p = 0.028），而G等位基因携带者的空腹血糖未降低（p = 0.686）。此外，通过合并干预组和对照组的基线测量值进行了一项具有更大统计效力的辅助研究，以测试碳水化合物/脂肪与脂蛋白脂肪酶基因型之间的横断面统计相互作用，用于胰岛素抵抗/胰岛素/空腹血糖的稳态模型评估。在rs328 G等位基因携带者中，碳水化合物摄入量增加与胰岛素抵抗和胰岛素的稳态模型评估呈正相关，但在CC纯合子中并非如此（交互作用p值为0.025）。这些结果表明，高碳水化合物饮食可能不适用于代谢综合征rs328 G等位基因携带者，这就需要为代谢综合征患者制定个性化的饮食干预措施。
