Wopereis Suzan, Stroeve Johanna H M, Stafleu Annette, Bakker Gertruud C M, Burggraaf Jacobus, van Erk Marjan J, Pellis Linette, Boessen Ruud, Kardinaal Alwine A F, van Ommen Ben
TNO, Netherlands Institute for Applied Scientific Research, Zeist, The Netherlands.
Centre for Human Drug Research (CHDR), Leiden, The Netherlands.
Genes Nutr. 2017 Aug 29;12:21. doi: 10.1186/s12263-017-0570-6. eCollection 2017.
A key feature of metabolic health is the ability to adapt upon dietary perturbations. Recently, it was shown that metabolic challenge tests in combination with the new generation biomarkers allow the simultaneous quantification of major metabolic health processes. Currently, applied challenge tests are largely non-standardized. A systematic review defined an optimal nutritional challenge test, the "PhenFlex test" (PFT). This study aimed to prove that PFT modulates all relevant processes governing metabolic health thereby allowing to distinguish subjects with different metabolic health status. Therefore, 20 healthy and 20 type 2 diabetic (T2D) male subjects were challenged both by PFT and oral glucose tolerance test (OGTT). During the 8-h response time course, 132 parameters were quantified that report on 26 metabolic processes distributed over 7 organs (gut, liver, adipose, pancreas, vasculature, muscle, kidney) and systemic stress.
In healthy subjects, 110 of the 132 parameters showed a time course response. Patients with T2D showed 18 parameters to be significantly different after overnight fasting compared to healthy subjects, while 58 parameters were different in the post-challenge time course after the PFT. This demonstrates the added value of PFT in distinguishing subjects with different health status. The OGTT and PFT response was highly comparable for glucose metabolism as identical amounts of glucose were present in both challenge tests. Yet the PFT reports on additional processes, including vasculature, systemic stress, and metabolic flexibility.
The PFT enables the quantification of all relevant metabolic processes involved in maintaining or regaining homeostasis of metabolic health. Studying both healthy subjects and subjects with impaired metabolic health showed that the PFT revealed new processes laying underneath health. This study provides the first evidence towards adopting the PFT as gold standard in nutrition research.
代谢健康的一个关键特征是能够适应饮食扰动。最近的研究表明，代谢挑战测试与新一代生物标志物相结合，可以同时对主要的代谢健康过程进行量化。目前，应用的挑战测试在很大程度上是非标准化的。一项系统评价定义了一种最佳营养挑战测试，即“PhenFlex测试”（PFT）。本研究旨在证明PFT能调节所有与代谢健康相关的过程，从而能够区分具有不同代谢健康状况的受试者。因此，对20名健康男性受试者和20名2型糖尿病（T2D）男性受试者进行了PFT和口服葡萄糖耐量试验（OGTT）。在8小时的反应时间过程中，对132个参数进行了量化，这些参数反映了分布在7个器官（肠道、肝脏、脂肪、胰腺、血管、肌肉、肾脏）的26个代谢过程以及全身应激情况。
在健康受试者中，132个参数中的110个显示出时间过程反应。与健康受试者相比，T2D患者在空腹过夜后有18个参数显著不同，而在PFT后的挑战后时间过程中有58个参数不同。这证明了PFT在区分不同健康状况受试者方面的附加价值。由于两种挑战测试中葡萄糖含量相同，OGTT和PFT对葡萄糖代谢的反应具有高度可比性。然而，PFT还报告了其他过程，包括血管、全身应激和代谢灵活性。
PFT能够对维持或恢复代谢健康稳态所涉及的所有相关代谢过程进行量化。对健康受试者和代谢健康受损受试者的研究表明，PFT揭示了健康背后的新过程。本研究为将PFT作为营养研究的金标准提供了首个证据。
