Experimental Surgery, McGill University, Montreal, QC, Canada.
Department of Anesthesia, McGill University, Montreal, QC, Canada.
Acta Anaesthesiol Scand. 2018 May;62(5):620-627. doi: 10.1111/aas.13069. Epub 2018 Jan 28.
Pre-operative complex carbohydrate (CHO) drinks are recommended to attenuate post-operative insulin resistance. However, many institutions use simple CHO drinks, which while convenient, may have less metabolic effects. Whey protein may enhance insulin release when added to complex CHO. The aim of this study was to compare the insulin response to simple CHO vs. simple CHO supplemented with whey protein.
Twelve healthy volunteers participated in this double-blinded, within subject, cross-over design study investigating insulin response to simple CHO drink vs. simple CHO + whey (CHO + W) drink. The primary outcome was the accumulated insulin response during 180 min after ingestion of the drinks (Area under the curve, AUC). Secondary outcomes included plasma glucose and ghrelin levels, and gastric emptying rate estimated by acetaminophen absorption technique. Data presented as mean (SD).
There was no differences in accumulated insulin response after the CHO or CHO + W drinks [AUC: 15 (8) vs. 20 (14) nmol/l, P = 0.27]. Insulin and glucose levels peaked between 30 and 60 min and reached 215 (95) pmol/l and 7 (1) mmol/l after the CHO drink and to 264 (232) pmol/l and 6.5 (1) mmol/l after the CHO + W drink. There were no differences in glucose or ghrelin levels or gastric emptying with the addition of whey.
The addition of whey protein to a simple CHO drink did not change the insulin response in healthy individuals. The peak insulin responses to simple CHO with or without whey protein were lower than that previously reported with complex CHO drinks. The impact of simple carbohydrate drinks with lower insulin response on peri-operative insulin sensitivity requires further study.
术前复合碳水化合物（CHO）饮料被推荐用于减轻术后胰岛素抵抗。然而，许多机构使用简单的 CHO 饮料，虽然方便，但代谢作用可能较小。乳清蛋白添加到复合 CHO 中可能会增强胰岛素的释放。本研究旨在比较简单 CHO 与添加乳清蛋白的简单 CHO 的胰岛素反应。
12 名健康志愿者参与了这项双盲、自身对照、交叉设计的研究，研究了简单 CHO 饮料与简单 CHO+乳清（CHO+W）饮料对胰岛素反应的影响。主要结果是摄入饮料后 180 分钟内累积胰岛素反应（曲线下面积，AUC）。次要结果包括血浆葡萄糖和胃饥饿素水平以及通过对乙酰氨基酚吸收技术估计的胃排空率。数据表示为平均值（标准差）。
CHO 或 CHO+W 饮料后累积胰岛素反应无差异[AUC：15（8）vs. 20（14）nmol/L，P=0.27]。胰岛素和葡萄糖水平在 30 至 60 分钟之间达到峰值，CHO 饮料后达到 215（95）pmol/L 和 7（1）mmol/L，CHO+W 饮料后达到 264（232）pmol/L 和 6.5（1）mmol/L。添加乳清蛋白后，葡萄糖或胃饥饿素水平或胃排空无差异。
在健康个体中，将乳清蛋白添加到简单的 CHO 饮料中不会改变胰岛素反应。简单 CHO 与乳清蛋白或不添加乳清蛋白的胰岛素峰值反应均低于先前报道的复杂 CHO 饮料。具有较低胰岛素反应的简单碳水化合物饮料对围手术期胰岛素敏感性的影响需要进一步研究。
