Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
University of Maryland School of Medicine.
Diabet Med. 2017 Oct;34(10):1407-1413. doi: 10.1111/dme.13391. Epub 2017 Jul 9.
To determine the effects of dietary changes in amount and type of carbohydrate on 1,5-anhydroglucitol levels.
We conducted an ancillary study to a completed, randomized clinical trial in overweight and obese adults without diabetes (N=159). Using a crossover design, participants were fed each one of four diets in turn for 5 weeks, with 2-week washout periods inbetween. The four diets were: high glycaemic index (≥65) with high proportion of carbohydrate (58% kcal) (GC); low glycaemic index (GI≤45) with low proportion of carbohydrate (40% kcal) (gc); low glycaemic index with high proportion of carbohydrate (gC); and high glycaemic index with low proportion of carbohydrate (Gc). Plasma 1,5-anhydroglucitol levels were measured at baseline and after each feeding period.
At baseline, participants had a mean age of 53 years (53% women, 52% non-Hispanic black, 50% obese). Their mean fasting glucose and 1,5-anhydroglucitol levels were 97 mg/dl (5.4 mmol/l) and 18.6 μg/mL (113.3 μmol/l), respectively. Compared with baseline, each of the four diets reduced 1,5-anhydroglucitol by a range of -2.4 to -3.7 μg/mL (-14.6 to -22.5 μmol/l); all P <0.001). Reducing either glycaemic index or proportion of carbohydrate lowered 1,5-anhydroglucitol levels. These effects were additive, such that reducing both glycaemic index and proportion of carbohydrates decreased 1,5-anhydroglucitol by -1.31 μg/mL [95% CI: -1.63, -0.99; P<0.001 or -8.0 (-9.9, -6.0) μmol/l]. Furthermore, these effects were confirmed in a subgroup of participants with 12-h glucose monitoring and no documented hyperglycaemia (fasting glucose <160 mg/dl or 8.9 mmol/l).
Both type and amount of dietary carbohydrate affect 1,5-anhydroglucitol plasma concentrations in adults without diabetes. This finding contradicts the long-standing notion that 1,5-anhydroglucitol remains at constant concentrations in the blood in the absence of hyperglycaemic excursions. (Clinical trials registry number: NCT00051350).
确定饮食中碳水化合物的数量和类型变化对 1,5-脱水葡萄糖醇水平的影响。
我们对一项已完成的、超重和肥胖成年人（无糖尿病）的随机临床试验进行了辅助研究（N=159）。采用交叉设计，参与者依次接受四种饮食中的每一种，每种饮食持续 5 周，其间有 2 周的洗脱期。这四种饮食是：高血糖指数（≥65）、高碳水化合物比例（58%卡路里）（GC）；低血糖指数（GI≤45）、低碳水化合物比例（40%卡路里）（gc）；低血糖指数、高碳水化合物比例（gC）；高血糖指数、低碳水化合物比例（Gc）。在基线和每个喂养期后测量血浆 1,5-脱水葡萄糖醇水平。
在基线时，参与者的平均年龄为 53 岁（53%为女性，52%为非西班牙裔黑人，50%为肥胖）。他们的空腹血糖和 1,5-脱水葡萄糖醇水平分别为 97mg/dl（5.4mmol/l）和 18.6μg/ml（113.3μmol/l）。与基线相比，四种饮食中的每一种都将 1,5-脱水葡萄糖醇降低了 2.4 到 3.7μg/ml（-14.6 到-22.5μmol/l）；所有 P<0.001）。降低血糖指数或碳水化合物比例都降低了 1,5-脱水葡萄糖醇水平。这些效果是累加的，例如，降低血糖指数和碳水化合物比例都降低了 1,5-脱水葡萄糖醇 1.31μg/ml[95%CI：-1.63，-0.99；P<0.001 或-8.0（-9.9，-6.0）μmol/l]。此外，在没有记录到高血糖（空腹血糖<160mg/dl 或 8.9mmol/l）的参与者亚组中，这些效果得到了证实。
饮食中碳水化合物的类型和数量都会影响无糖尿病成年人的 1,5-脱水葡萄糖醇血浆浓度。这一发现与长期以来的观点相矛盾，即 1,5-脱水葡萄糖醇在没有高血糖波动的情况下，其在血液中的浓度保持不变。（临床试验注册号：NCT00051350）。
