Institut de Recherches Cliniques de Montréal (IRCM) and Université de Montréal, Montréal, Québec, Canada.
Institut de Recherches Cliniques de Montréal (IRCM) and Université de Montréal, Montréal, Québec, Canada.
Nutr Metab Cardiovasc Dis. 2019 May;29(5):504-512. doi: 10.1016/j.numecd.2019.01.014. Epub 2019 Feb 5.
Higher fiber intake is associated with increased insulin sensitivity (IS) and reduced glucose-induced insulin secretion (GIIS) during isocaloric-diets; however, its role in hypocaloric-diets is unclear. We examined whether increased fiber intake predicts the amelioration in IS and GIIS following a hypocaloric-diet.
This is a post-hoc analysis of 55 adult subjects (BMI > 27 kg/m) who completed a 6-month hypocaloric-diet (-500 kcal/day). Dietary intake was assessed using 3-day food records at baseline and post-intervention. We evaluated glucose-induced insulin and C-peptide secretions as AUC of plasma insulin and C-peptide during intravenous-glucose-tolerance tests (IVGTT) and IS via hyperinsulinemic-euglycemic clamps. Data analysis employed regression models and 2-way RM ANOVAs. Post-intervention % change in fiber intake was associated positively with IS (r = 0.30) and negatively with % change in total (r = -0.37) and 2nd phase GIIS (r = -0.44) but not C-peptide secretion. It remained associated with lower 2nd phase GIIS after adjustment for sex and % changes in BMI and energy-intake, independently of other macronutrients. Subjects who increased fiber intake (to 28.7 ± 9.0 g/day) had a greater decrease in 2nd phase GIIS not C-peptide secretion, independently of sex or changes in adiposity or energy-intake compared to subjects who decreased intake (to 20.0 ± 6.8 g/day).
Higher fiber intake is an independent predictor of reduced 2nd phase glucose-induced hyperinsulinemia after a hypocaloric-diet. It was not associated with plasma C-peptide, suggesting a role in faster insulin clearance rather reduced insulin secretion. Promoting high-fiber intake may increase the effectiveness of hypocaloric-diets in preventing type 2 diabetes.
ISRCTN14476404, BioMedCentral.com.
This trial was registered at BioMed Central as ISRCTN14476404, on July 28th, 2017.
在等热量饮食中，较高的膳食纤维摄入量与胰岛素敏感性（IS）的提高和葡萄糖诱导的胰岛素分泌（GIIS）减少有关；然而，其在低热量饮食中的作用尚不清楚。我们研究了膳食纤维摄入量的增加是否可以预测低热量饮食后 IS 和 GIIS 的改善。
这是对 55 名成年受试者（BMI>27kg/m）进行的一项 6 个月低热量饮食（-500kcal/天）的事后分析。在基线和干预后使用 3 天食物记录评估膳食摄入量。我们通过静脉葡萄糖耐量试验（IVGTT）评估了葡萄糖诱导的胰岛素和 C 肽分泌，将胰岛素和 C 肽的血浆 AUC 作为评估指标，并通过高胰岛素正葡萄糖钳夹技术评估了 IS。数据分析采用回归模型和双因素重复测量方差分析。干预后膳食纤维摄入量的百分比变化与 IS 呈正相关（r=0.30），与总（r=-0.37）和第 2 时相 GIIS（r=-0.44）的百分比变化呈负相关，但与 C 肽分泌无关。在调整性别以及 BMI 和能量摄入的百分比变化后，它与第 2 时相 GIIS 的降低仍然相关，这与其他宏量营养素无关。与摄入减少的受试者（20.0±6.8g/天）相比，摄入增加的受试者（28.7±9.0g/天）的第 2 时相 GIIS 下降更大，而 C 肽分泌无明显变化，无论性别或肥胖或能量摄入的变化如何。
低热量饮食后，膳食纤维摄入量较高是第 2 时相葡萄糖诱导的高胰岛素血症降低的独立预测因素。它与血浆 C 肽无关，提示其在加速胰岛素清除而非减少胰岛素分泌方面发挥作用。促进高膳食纤维摄入可能会提高低热量饮食预防 2 型糖尿病的效果。
ISRCTN14476404，BioMedCentral.com。
本试验于 2017 年 7 月 28 日在 BioMed Central 登记为 ISRCTN14476404。
