蛋白质和脂质预负荷对2型糖尿病患者葡萄糖耐量的持续影响。

Sustained effects of a protein and lipid preload on glucose tolerance in type 2 diabetes patients.

作者信息

Tricò D, Filice E, Baldi S, Frascerra S, Mari A, Natali A

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

出版信息

Diabetes Metab. 2016 Sep;42(4):242-8. doi: 10.1016/j.diabet.2016.03.004. Epub 2016 Apr 12.

DOI:10.1016/j.diabet.2016.03.004

PMID:27084589

Abstract

BACKGROUND

Small amounts of nutrients given as a 'preload' can reduce post-meal hyperglycaemic peaks in type 2 diabetes (T2D) patients by activating a number of mechanisms involved in glucose homoeostasis. This study was undertaken to ascertain whether this positive effect extends to the late absorptive phase and to identify the main mechanisms involved.

MATERIAL AND METHODS

Eight well-controlled T2D patients, aged 40-70 years, were randomized to consume a 'preload' of either water or non-glucidic nutrients (50g of Parmesan cheese, one boiled egg) 30min before a 300-min oral glucose tolerance test.

RESULTS

After the nutrient preload, significant reductions were observed in peak glucose (-49%; P<0.02), total plasma glucose (iAUC: -28%; P<0.03), exogenous glucose (iAUC: -30%; P<0.03) and insulin clearance (-28%; P<0.04), with enhancement of insulin secretion (iAUC: +22%; P<0.003). These effects were associated with higher plasma levels of GLP-1 (iAUC: +463%; P<0.002), GIP (iAUC: +152%; P<0.0003) and glucagon (iAUC: +144%; P<0.0002).

CONCLUSION

In T2D patients, a protein and lipid preload improves glucose tolerance throughout the whole post-absorptive phase mainly by reducing the appearance of oral glucose, and improving both beta-cell function and insulin bioavailability.

摘要

背景

作为“预负荷”给予少量营养素可通过激活参与葡萄糖稳态的多种机制来降低2型糖尿病（T2D）患者餐后血糖高峰。本研究旨在确定这种积极作用是否会延伸至吸收后期，并确定其中的主要机制。

材料与方法

8名年龄在40 - 70岁、病情控制良好的T2D患者被随机分为两组，在进行300分钟口服葡萄糖耐量试验前30分钟，一组饮用“预负荷”水，另一组食用非糖类营养素（50克帕尔马干酪、一个煮鸡蛋）。

结果

给予营养素预负荷后，观察到血糖峰值显著降低（-49%；P<0.02）、血浆葡萄糖总量（iAUC：-28%；P<0.03）、外源性葡萄糖（iAUC：-30%；P<0.03）和胰岛素清除率（-28%；P<0.04），同时胰岛素分泌增强（iAUC：+22%；P<0.003）。这些作用与血浆中胰高血糖素样肽-1（GLP-1）水平升高（iAUC：+463%；P<0.002）、葡萄糖依赖性促胰岛素多肽（GIP）水平升高（iAUC：+152%；P<0.0003）和胰高血糖素水平升高（iAUC：+144%；P<0.0002）相关。