Kahleova Hana, Klementova Marta, Herynek Vit, Skoch Antonin, Herynek Stepan, Hill Martin, Mari Andrea, Pelikanova Terezie
a Institute for Clinical and Experimental Medicine , Prague , Czech Republic.
b Physicians Committee for Responsible Medicine , Washington , DC.
J Am Coll Nutr. 2017 Jul;36(5):364-369. doi: 10.1080/07315724.2017.1302367. Epub 2017 Jun 10.
The aim of our study was to compare the effects of a vegetarian and a conventional diet on thigh adipose tissue distribution in subjects with type 2 diabetes (T2D).
Seventy-four subjects with T2D were randomly assigned to either follow a vegetarian diet (V, n = 37) or a control group who followed an isocaloric conventional anti-diabetic diet (C, n = 37). Both diets were calorie restricted (-500 kcal/day). To measure insulin sensitivity, the hyperinsulinemic (1 mU.kg.min) isoglycemic clamp was conducted. β-Cell function was assessed using a mathematical model after a test meal. Magnetic resonance imaging of the thigh was performed. All subjects were examined at 0, 3, and 6 months. Statistical analyses were performed using repeated measures analysis of variance and a multivariate regression model.
Greater reduction was observed in total leg area in V (-13.6 cm [95% confidence interval [CI], -14.2 to -12.9] in V vs -9.9 cm [95% CI, -10.6 to -9.2] in C; Gxt p < 0.001). The reduction in subcutaneous fat was comparable in response to both diets (Gxt, p = 0.64). Subfascial fat was reduced only in response to a vegetarian diet (-0.82 [95% CI, -1.13 to -0.55] cm in V vs -0.44 [95% CI, -0.78 to +0.02] cm in C; Gxt, p = 0.04). The reduction in intramuscular fat tended to be greater in response to a vegetarian diet (-1.78 [95% CI, -2.26 to -1.27] cm in V vs -0.57 [95% CI, -1.06 to -0.09] cm in C; Gxt, p = 0.12). Changes in subcutaneous and subfascial fat correlated with changes in glycated hemoglobin (HbA1c), fasting plasma glucose, and β-cell insulin sensitivity. After adjustment for changes in body mass index (BMI), correlations remained significant for changes in fasting plasma glucose and β-cell insulin sensitivity and with changes in triglycerides.
Our data indicate the importance of both subcutaneous and subfascial fat in relationship to glucose and lipid metabolism.
BMI , body mass index; C , control group; FPG , fasting plasma glucose; Gxt , interaction between group and time; HbA1c , glycated hemoglobin; MCR , metabolic clearance rate of glucose; OPLS , orthogonal projections to latent structure; T2D , type 2 diabetes; V , vegetarian group.
我们研究的目的是比较素食和传统饮食对2型糖尿病（T2D）患者大腿脂肪组织分布的影响。
74名T2D患者被随机分配，要么遵循素食饮食（V组，n = 37），要么遵循等热量传统抗糖尿病饮食的对照组（C组，n = 37）。两种饮食均限制热量摄入（-500千卡/天）。为测量胰岛素敏感性，进行了高胰岛素血症（1 mU·kg·min）等血糖钳夹试验。使用测试餐后的数学模型评估β细胞功能。对大腿进行磁共振成像。所有受试者在0、3和6个月时接受检查。使用重复测量方差分析和多元回归模型进行统计分析。
V组总腿部面积减少更明显（V组减少13.6厘米[95%置信区间[CI]，-14.2至-12.9]，C组减少9.9厘米[95% CI，-10.6至-9.2]；组间与时间交互作用，p < 0.001）。两种饮食对皮下脂肪减少的反应相当（组间与时间交互作用，p = 0.64）。仅素食饮食可使筋膜下脂肪减少（V组减少0.82[95% CI，-1.13至-0.55]厘米，C组减少0.44[95% CI，-0.78至+0.02]厘米；组间与时间交互作用，p = 0.04）。素食饮食对肌肉内脂肪减少的趋势更大（V组减少1.78[95% CI，-2.26至-1.27]厘米，C组减少0.57[95% CI，-1.06至-0.09]厘米；组间与时间交互作用，p = 0.12）。皮下和筋膜下脂肪的变化与糖化血红蛋白（HbA1c）、空腹血糖和β细胞胰岛素敏感性的变化相关。在调整体重指数（BMI）变化后，空腹血糖和β细胞胰岛素敏感性的变化以及甘油三酯变化的相关性仍然显著。
我们的数据表明皮下和筋膜下脂肪在与葡萄糖和脂质代谢关系中的重要性。
BMI，体重指数；C，对照组；FPG，空腹血糖；Gxt，组间与时间交互作用；HbA1c，糖化血红蛋白；MCR，葡萄糖代谢清除率；OPLS，潜在结构的正交投影；T2D，2型糖尿病；V，素食组
