在2型糖尿病患者中，旧石器时代饮食比糖尿病饮食更能降低空腹血浆瘦素浓度：一项随机交叉试验。
Palaeolithic diet decreases fasting plasma leptin concentrations more than a diabetes diet in patients with type 2 diabetes: a randomised cross-over trial.
作者信息
Fontes-Villalba Maelán, Lindeberg Staffan, Granfeldt Yvonne, Knop Filip K, Memon Ashfaque A, Carrera-Bastos Pedro, Picazo Óscar, Chanrai Madhvi, Sunquist Jan, Sundquist Kristina, Jönsson Tommy
机构信息
Clinical Research Centre, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
, Calle José Betancort, 15, 35530, Teguise-Lanzarote, Spain.
出版信息
Cardiovasc Diabetol. 2016 May 23;15:80. doi: 10.1186/s12933-016-0398-1.
BACKGROUND
We have previously shown that a Palaeolithic diet consisting of the typical food groups that our ancestors ate during the Palaeolithic era, improves cardiovascular disease risk factors and glucose control compared to the currently recommended diabetes diet in patients with type 2 diabetes. To elucidate the mechanisms behind these effects, we evaluated fasting plasma concentrations of glucagon, insulin, incretins, ghrelin, C-peptide and adipokines from the same study.
METHODS
In a randomised, open-label, cross-over study, 13 patients with type 2 diabetes were randomly assigned to eat a Palaeolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts, or a diabetes diet designed in accordance with current diabetes dietary guidelines during two consecutive 3-month periods. The patients were recruited from primary health-care units and included three women and 10 men [age (mean ± SD) 64 ± 6 years; BMI 30 ± 7 kg/m(2); diabetes duration 8 ± 5 years; glycated haemoglobin 6.6 ± 0.6 % (57.3 ± 6 mmol/mol)] with unaltered diabetes treatment and stable body weight for 3 months prior to the start of the study. Outcome variables included fasting plasma concentrations of leptin, adiponectin, adipsin, visfatin, resistin, glucagon, insulin, C-peptide, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 and ghrelin. Dietary intake was evaluated by use of 4-day weighed food records.
RESULTS
Seven participants started with the Palaeolithic diet and six with the diabetes diet. The Palaeolithic diet resulted in a large effect size (Cohen's d = -1.26) at lowering fasting plasma leptin levels compared to the diabetes diet [mean difference (95 % CI), -2.3 (-5.1 to 0.4) ng/ml, p = 0.023]. No statistically significant differences between the diets for the other variables, analysed in this study, were observed.
CONCLUSIONS
Over a 3-month study period, a Palaeolithic diet resulted in reduced fasting plasma leptin levels, but did not change fasting levels of insulin, C-peptide, glucagon, incretins, ghrelin and adipokines compared to the currently recommended diabetes diet.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00435240.
背景
我们之前已经表明，与目前推荐给2型糖尿病患者的糖尿病饮食相比，由我们祖先在旧石器时代食用的典型食物组构成的旧石器时代饮食可改善心血管疾病风险因素和血糖控制。为了阐明这些效应背后的机制，我们评估了来自同一研究的空腹血浆中胰高血糖素、胰岛素、肠促胰岛素、胃饥饿素、C肽和脂肪因子的浓度。
方法
在一项随机、开放标签、交叉研究中，13名2型糖尿病患者被随机分配在连续两个3个月期间，要么食用基于瘦肉、鱼类、水果、蔬菜、块根类蔬菜、鸡蛋和坚果的旧石器时代饮食，要么食用根据当前糖尿病饮食指南设计的糖尿病饮食。患者从初级保健单位招募，包括3名女性和10名男性[年龄（均值±标准差）64±6岁；体重指数30±7kg/m²；糖尿病病程8±5年；糖化血红蛋白6.6±0.6%（57.3±6mmol/mol）]，在研究开始前3个月糖尿病治疗未改变且体重稳定。结局变量包括空腹血浆中瘦素、脂联素、脂肪酶、内脏脂肪素、抵抗素、胰高血糖素、胰岛素、C肽、葡萄糖依赖性促胰岛素多肽、胰高血糖素样肽-1和胃饥饿素的浓度。通过4天的称重食物记录评估饮食摄入量。
结果
7名参与者从旧石器时代饮食开始，6名从糖尿病饮食开始。与糖尿病饮食相比，旧石器时代饮食在降低空腹血浆瘦素水平方面产生了较大的效应量（科恩d值=-1.26）[平均差异（95%CI），-2.3（-5.1至0.4）ng/ml，p=0.023]。在本研究中分析的其他变量方面，未观察到两种饮食之间有统计学显著差异。
结论
在为期3个月的研究期间，与目前推荐的糖尿病饮食相比，旧石器时代饮食导致空腹血浆瘦素水平降低，但未改变胰岛素、C肽、胰高血糖素、肠促胰岛素、胃饥饿素和脂肪因子的空腹水平。试验注册：ClinicalTrials.gov NCT00435240。
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